The Epidemiology of Venous Thromboembolism in the Community

Heit, John A.

doi:10.1161/atvbaha.108.162545

Cited by 706 publications

(519 citation statements)

References 46 publications

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“…1 The clinical outcome of acute PE varies widely, from mild symptoms and no hemodynamic consequences to cardiovascular collapse and respiratory failure. 2 The American Heart Association (AHA) consensus guidelines recommend risk stratification of PE patients to guide appropriate and timely management and disposition.…”

Section: Introductionmentioning

confidence: 99%

Association Between Electrocardiographic Findings, Right Heart Strain, and Short‐Term Adverse Clinical Events in Patients With Acute Pulmonary Embolism

Hariharan

Dudzinski

Okechukwu

et al. 2015

Clinical Cardiology

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Background: Electrocardiographic (ECG) changes may be seen with pulmonary emboli (PE). Whether ECG is associated with short-term adverse clinical events after PE is less well established. Hypothesis: ECG findings are associated with short-term clinical deterioration after PE. Methods: Consecutive adult PE patients were enrolled in an academic emergency department from 2008 to 2011. The primary outcome was right heart strain (RHS) on echocardiogram or CT pulmonary angiography, or TnT ≥0.1 ng/mL. We derived an ECG (TwiST) score that is associated with RHS and short-term adverse clinical events. Results: We enrolled 298 patients with PE. On multivariate analysis, T-wave inversion in leads V 1 through V 3 (OR: 4.7, 95% confidence interval [CI]: 1.7-13.2), S wave in lead I (OR: 2.0, 95% CI: 1.1-3.5), and tachycardia (OR: 2.5, 95% CI: 1.3-4.8) were associated with RHS. A TwiST score ≤2 (n = 210, 72%) was 84% (95% CI: 77%-90%) sensitive for the absence of RHS, whereas a TwiST score ≥5 (n = 47, 16%) was 93% (95% CI: 88%-97%) specific for the presence of RHS. Conclusions: A simple ECG (TwiST) score can identify patients likely or not likely to have RHS with >80% specificity and sensitivity and may assist in identifying patients with acute PE at risk for adverse clinical events before pursuing other advanced imaging tests.

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Section: Introductionmentioning

confidence: 99%

Association Between Electrocardiographic Findings, Right Heart Strain, and Short‐Term Adverse Clinical Events in Patients With Acute Pulmonary Embolism

Hariharan

Dudzinski

Okechukwu

et al. 2015

Clinical Cardiology

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“…1 Because the risk of recurrence increases in proportion to body mass index, individuals who are overweight or obese face nearly double the risk observed in normal-weight patients. 2 To minimize the likelihood of recurrent VTE, aggressive weight-based dosing formulas have been developed to help achieve prompt therapeutic anticoagulation with unfractionated heparin.…”

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confidence: 99%

Dosing of Unfractionated Heparin in Obese Patients with Venous Thromboembolism

et al. 2010

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“…Old-aged patients with DVT showed no statistically significant difference of the FMD compared to the young-middle-aged patients with DVT (6.7±5.3% vs. 6.8±5.7%, p=0.932; Fig. 2 Ageno et al 2008;Heit 2008;Isma et al 2009;Holst et al 2010). A common denominator might be represented by endothelial dysfunction.…”

Section: Resultsmentioning

confidence: 87%

Idiopathic deep venous thrombosis and arterial endothelial dysfunction in the elderly

Mazzoccoli

Fontana

Grilli

et al. 2011

AGE

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Arterial and venous thrombosis have always been regarded as different pathologies and epidemiological studies have examined the association between venous thrombosis and indicators of atherosclerosis and/or arterial thromboembolic events. We measured the flow-mediated dilation (FMD), a well-known marker of arterial endothelial dysfunction, in youngmiddle-aged and old-aged patients with and without unprovoked deep venous thrombosis (DVT). The aim of this study was to investigate whether DVT was a significant predictor for impaired FMD, considering all the patients and young-middle-aged (age<65 years) and old-aged (age≥65 years) patients separately. FMD was measured in the brachial artery on a population of 120 subjects with the same atherosclerosis risk factors, 68 male and 52 female, 70 young-middleaged subjects (mean age±SD 49.5±10.5 years) and 50 old-aged subjects (76.2±7.7 years). Patients with DVT showed a significant decrease of FMD compared to patients without DVT (6.8±5.5% vs. 10.9±3.5%, p<0.001). Moreover, old-aged patients showed a significant decrease of FMD compared to the young-middle-aged subjects (7.4±4.1% vs. 9.8± 5.3%, p=0.005). In the whole study population, DVT was strongly associated with FMD (risk factors adjusted β=−4.14, p<0.001). A significant interaction between age and the presence of DVT on predicting FMD was found (p=0.003) suggesting a AGE (2012) differential behavior of DVT as predictor of FMD. In young-middle-aged group, multivariate model confirmed that DVT was the most significant predictor of continuous FMD (β=−6.06, p<0.001). On the contrary, DVT was no more a predictor of FMD in the old age group (β=−0.73, p=0.556). Furthermore, old-aged patients without DVT showed a statistically significant decrease of FMD compared to the youngmiddle-aged subjects without DVT (8.2±2.1% vs. 12.6±2.7%, p<0.001) and old-aged patients with DVT showed a not statistically significant decrease of the FMD compared to the young-middle-aged patients with DVT (6.7±5.3% vs. 6.8±5.7%, p= 0.932). In conclusion, young-middle-aged patients with spontaneous DVT show an impaired FMD, whereas this impairment in old-aged subjects is evident independently from the presence or absence of DVT. Aging per se may be associated with physiologic abnormalities in the systemic arteries and with endothelial dysfunction.34:751-760 DOI 10.1007/s11357-011-9265-

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The Epidemiology of Venous Thromboembolism in the Community

Cited by 706 publications

References 46 publications

Association Between Electrocardiographic Findings, Right Heart Strain, and Short‐Term Adverse Clinical Events in Patients With Acute Pulmonary Embolism

Association Between Electrocardiographic Findings, Right Heart Strain, and Short‐Term Adverse Clinical Events in Patients With Acute Pulmonary Embolism

Dosing of Unfractionated Heparin in Obese Patients with Venous Thromboembolism

Idiopathic deep venous thrombosis and arterial endothelial dysfunction in the elderly

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