Recurrence of venous thromboembolism in patients with recent gestational deep vein thrombosis or pulmonary embolism: Findings from the RIETE Registry

Barillari, Giovanni; Londero, Ambrogio P.; Brenner, Benjamin; Nauffal, Dolores; Muñoz-Torrero, Juan Francisco Sánchez; Molino, Fátima del; Moustafa, Farès; Madridano, Olga; Martín-Martos, F.; Monreal, Manuel; Décousus, Hervé; Prandoni, Paolo; Barba, Raquel; Micco, Pierpaolo Di; Bertoletti, Laurent; Schellong, Sebastian; Tzoran, Inna; Reis, Abílio; Bosevski, Marijan; Bounameaux, Henri; Malý, Radován; Wells, Philip S.; Papadakis, Manolis

doi:10.1016/j.ejim.2016.02.013

Cited by 13 publications

(9 citation statements)

References 24 publications

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“…2 In a large retrospective study, the cumulative incidence of recurrent VTE up to 60 months after the index VTE event was significantly higher in women aged 18 to 46 years with unprovoked VTE compared with pregnancy (or postpartum)-associated VTE (10.4% and 5.8%, respectively; P < .02; adjusted HR, 0.6; 95% CI, 0.4-0.9). 30 More recently, the Registro Informatizado de Enfermedad TromboEmbólica (Computerized Registry of Patients with Venous Thromboembolism) investigators reported a 2-year VTE recurrence rate of 3.3% for women whose initial event was pregnancy (or postpartum) associated. 31 Collectively, these data suggest that limited duration anticoagulation may be appropriate for most women with prior pregnancy-associated VTE, after close follow-up and personalized assessment of risk factors as outlined in Figure 2.…”

Section: Vte Recurrence Risk In Nonpregnant Women Whose Initial Eventmentioning

confidence: 99%

Which patients are at high risk of recurrent venous thromboembolism (deep vein thrombosis and pulmonary embolism)?

Áinle

Kevane

2020

Hematology

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Recurrent venous thromboembolism (VTE, or deep vein thrombosis and pulmonary embolism) is associated with mortality and long-term morbidity. The circumstances in which an index VTE event occurred are crucial when personalized VTE recurrence risk is assessed. Patients who experience a VTE event in the setting of a transient major risk factor (such as surgery associated with general anesthesia for >30 minutes) are predicted to have a low VTE recurrence risk following discontinuation of anticoagulation, and limited-duration anticoagulation is generally recommended. In contrast, those patients whose VTE event occurred in the absence of risk factors or who have persistent risk factors have a higher VTE recurrence risk. Here, we review the literature surrounding VTE recurrence risk in a range of clinical conditions. We describe gender-specific risks, including VTE recurrence risk following hormone- and pregnancy-associated VTE events. Finally, we discuss how the competing impacts of VTE recurrence and bleeding have shaped international guideline recommendations.

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Section: Vte Recurrence Risk In Nonpregnant Women Whose Initial Eventmentioning

confidence: 99%

Which patients are at high risk of recurrent venous thromboembolism (deep vein thrombosis and pulmonary embolism)?

Áinle

Kevane

2020

Hematology

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“…Fortunately, the early stages of endometrial cancer have a very favorable prognosis with a recurrence-free survival of 90% at 5 years [ 48 ]. However, this does also mean there will be a low number of negative events, which implies the need for large sample sizes that can be reached only with large multicentric randomized controlled trials or with widely adopted international registries, such as RIETE (Registro Informatizado de la Enfermedad ThromboEmbolica) [ 49 ].…”

Section: Discussionmentioning

confidence: 99%

Hormone Replacement Therapy in Endometrial Cancer Survivors: A Meta-Analysis

Londero

Parisi

Tassi

et al. 2021

JCM

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The purpose of this study is to investigate the effect of hormone therapy (HT) on the oncological outcomes of endometrial cancer (EC) survivors. A systematic literature review was conducted in July 2021 to identify studies detailing the effect size for the relationship between HT use in EC and oncological outcomes (survival and disease recurrence). This included studies that evaluated the different recurrence rates among women treated for EC who subsequently underwent HT and those who did not. The collected studies were evaluated for quality, heterogeneity, and publication bias, and a pooled odds ratio (OR) or hazard ratio (HR) was calculated with a confidence interval of 95% (95% CI). In total, 5291 studies were collated, and after the review process, one randomized trial and seven observational studies were included, comprising 1801 EC survivors treated with HT and 6015 controls. The time-dependent analysis could be conducted for four studies, and considering the disease-free survival, the pooled HR of 0.90 (95% CI 0.28 to 2.87) showed no significant differences. However, among Black American women treated with continuous estrogen HT, the HR was 7.58 (95% CI 1.96 to 29.31), showing a significantly increased risk of recurrence for women in this ethnic group. Considering the pooled OR of all included studies 0.63 (95% CI 0.48 to 0.83), a significantly reduced risk of recurrence was found among EC survivors treated with HT. Considering the type of HT, the most risk-reducing was combined estrogen and progestin therapy and the cyclic regimen. Although supporting evidence is based mainly upon observational studies, evidence of no increased risk or even decreased risk was generally found, apart from in Black American women where a significantly increased recurrence risk was evident. The data are rather reassuring for the short-term administration of HT to symptomatic EC survivors. Future studies with a longer follow-up are necessary to better clarify the long-term effects of HT.

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“…In women with a personal history of VTE, pregnancy also carries a risk of VTE recurrence. The RIETE registry restricted to women affected by VTE during pregnancy showed a 3.3% (1.5-5%) risk of recurrence at 2 years i.e., 2.3 recurrences per 100 patient-years (15). In the 2002 Vienna study, a new pregnancy increased that risk (RR: 3.5 (1.5-7.8) (16).…”

Section: Risk Factors For Vte Around Pregnancymentioning

confidence: 97%

The Risk of Thrombosis Around Pregnancy: Where Do We Stand?

Gris

Guillotin

Chéa

et al. 2022

Front. Cardiovasc. Med.

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Pregnancy and puerperium increase the relative risk of venous thromboembolism (VTE) and the absolute risk remains low, around 1 per 1,000, with induced mortality of around 1 per 100,000. Analysis of large databases has helped specify the modes of presentation and risk factors (RF) whose impact is greater after than before childbirth, since VTE during pregnancy and post-partum obey different RFs. The evolution of the population concerned (mostly women over 35, obese, of multi-ethnicity undergoing medically assisted reproduction) affects the frequency of these RFs. Pulmonary embolism (PE) is over-represented after childbirth, but 30% of PE in pregnancy occurs without any RFs. Recommendations for prevention, mainly from expert groups, are heterogeneous and often discordant. Low molecular weight heparins (LMWH) are the mainstay of pharmacological thromboprophylaxis, in a field where randomized controlled studies are definitely lacking. VTE risk assessment in pregnancy must be systematic and repetitive. Risk assessment methods and scores are beginning to emerge to guide thromboprophylaxis and should be used more systematically. In the future, analyzing observational data from huge, nationwide registries and prospective cluster clinical trials may bring to light clinically relevant outcomes likely to feed comprehensive guidelines.

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Recurrence of venous thromboembolism in patients with recent gestational deep vein thrombosis or pulmonary embolism: Findings from the RIETE Registry

Cited by 13 publications

References 24 publications

Which patients are at high risk of recurrent venous thromboembolism (deep vein thrombosis and pulmonary embolism)?

Which patients are at high risk of recurrent venous thromboembolism (deep vein thrombosis and pulmonary embolism)?

Hormone Replacement Therapy in Endometrial Cancer Survivors: A Meta-Analysis

The Risk of Thrombosis Around Pregnancy: Where Do We Stand?

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