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Long-Term Anticoagulant Therapy of Patients with Venous Thromboembolism. What Are the Practices?

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dc.contributor.author Mahé, Isabelle
dc.contributor.author Sterpu, Raluca
dc.contributor.author Bertoletti, Laurent
dc.contributor.author López-Jiménez, Luciano
dc.contributor.author Mellado Joan, Meritxell
dc.contributor.author Trujillo-Santos, Javier
dc.contributor.author Ballaz, Aitor
dc.contributor.author Hernández Blasco, Luis Manuel
dc.contributor.author Marchena, Pablo Javier
dc.contributor.author Monreal, Manuel
dc.contributor.author RIETE investigators
dc.date.accessioned 2015-10-08T10:51:58Z
dc.date.available 2015-10-08T10:51:58Z
dc.date.issued 2015
dc.identifier.citation Mahé I, Sterpu R, Bertoletti L, López-Jiménez L, Mellado Joan M, Trujillo-Santos J. et al. Long-Term Anticoagulant Therapy of Patients with Venous Thromboembolism. What Are the Practices? PLoS One. 2015 Jun 15;10(6):e0128741. doi: 10.1371/journal.pone.0128741.
dc.identifier.issn 1932-6203
dc.identifier.uri http://hdl.handle.net/10230/24822
dc.description.abstract Current guidelines of antithrombotic therapy suggest early initiation of vitamin K antagonists (VKA) in non-cancer patients with venous thromboembolism (VTE), and long-term therapy with low-molecular weight heparin (LMWH) for those with cancer. We used data from RIETE (international registry of patients with VTE) to report the use of long-term anticoagulant therapy over time and to identify predictors of anticoagulant choice (regarding international guidelines) in patients with- and without cancer. Among 35,280 patients without cancer, 82% received long-term VKA (but 17% started after the first week). Among 4,378 patients with cancer, 66% received long term LMWH as monotherapy. In patients without cancer, recent bleeding (odds ratio [OR] 2.70, 95% CI 2.26-3.23), age >70 years (OR 1.15, 95% CI 1.06-1.24), immobility (OR 2.06, 95% CI 1.93-2.19), renal insufficiency (OR 2.42, 95% CI 2.15-2.71) and anemia (OR 1.75, 95% CI 1.65-1.87) predicted poor adherence to guidelines. In those with cancer, anemia (OR 1.83, 95% CI 1.64-2.06), immobility (OR 1.51, 95% CI 1.30-1.76) and metastases (OR 3.22, 95% CI 2.87-3.61) predicted long-term LMWH therapy. In conclusion, we report practices of VTE therapy in real life and found that a significant proportion of patients did not receive the recommended treatment. The perceived increased risk for bleeding has an impact on anticoagulant treatment decision.
dc.description.sponsorship This Registry is supported by unrestricted educational grants from Sanofi Spain and Bayer Pharma AG. The funding source had no role in the design, protocol development, or conduct of the study; data collection, management, or analysis; interpretation, preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication. The RIETE Registry was supported with an unrestricted educational grant from Sanofi Spain and Bayer Pharma AG. Bayer Pharma AG’s support was limited to the part of RIETE outside Spain, which accounts for a 20.05% of the total patients included in the RIETE Registry. The authors have nothing to disclose. The authors have declared that no competing interests exist.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher Public Library of Science
dc.rights © 2015 Mahé et al. This is an open access article distributed under the terms of the http://creativecommons.org/licenses/by/4.0/, which permits/nunrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
dc.rights.uri http://creativecommons.org/licenses/by/4.0/
dc.subject.other Anticoagulants (Medicina)
dc.subject.other Trombosi -- Tractament
dc.title Long-Term Anticoagulant Therapy of Patients with Venous Thromboembolism. What Are the Practices?
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1371/journal.pone.0128741
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/publishedVersion

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