The management of acute venous thromboembolism in clinical practice

Abstract

SummaryVenous thromboembolism (VTE) is a significant cause of morbidity and mortality in Europe. Data from real-world registries are necessary, as clinical trials do not represent the full spectrum of VTE patients seen in clinical practice. We aimed to document the epidemiology, management and outcomes of VTE using data from a large, observational database. PREFER in VTE was an international, non-interventional disease registry conducted between January 2013 and July 2015 in primary and secondary care across seven European countries. Consecutive patients with acute VTE were documented and followed up over 12 months. PREFER in VTE included 3,455 patients with a mean age of 60.8 ± 17.0 years. Overall, 53.0% were male. The majority of patients were assessed in the hospital setting as inpatients or outpatients (78.5%). The diagnosis was deep-vein thrombosis (DVT) in 59.5% and pulmonary embolism (PE) in 40.5%. The most common comorbidities were the various types of cardiovascular disease (excluding hypertension; 45.5%), hypertension (42.3%) and dyslipidaemia (21.1%). Following the index VTE, a large proportion of patients received initial therapy with heparin (73.2%), almost half received a vitamin K antagonist (48.7%) and nearly a quarter received a DOAC (24.5%). Almost a quarter of all presentations were for recurrent VTE, with >80% of previous episodes having occurred more than 12 months prior to baseline. In conclusion, PREFER in VTE has provided contemporary insights into VTE patients and their real-world management, including their baseline characteristics, risk factors, disease history, symptoms and signs, initial therapy and outcomes.

Acute Pulmonary Embolism in Dual Dengue Fever and Influenza B Infection

“…Our patient with mild deficiency of proteins C ad S might not be detectably associated with a risk of thrombosis, but which could be provoked by dual severe dengue fever and influenza infection. In this patient, several risk factors other than low plasma concentration of protein C and S, such as hypertension, diabetes, age over 70 and obesity (height: 160 cm, weight: 93.6 Kg, body mass index: 36.6) could probably contribute to pulmonary embolism [8,9]. Therefore, we could not exclude a possibility of anecdotal evidence for PE in the context of dengue fever and influenza B infection.…”

Pulmonary embolism in Europe - Burden of illness in relationship to healthcare resource utilization and return to work

“…For regional comparisons, Austria, Switzerland, and Germany were combined into one pre-specified region label (DACH). More detail of clinical variables can be found elsewhere [16].…”

COSIMO – patients with active cancer changing to rivaroxaban for the treatment and prevention of recurrent venous thromboembolism: a non-interventional study

“…chemotherapeutic or anti-angiogenic agents) are well-established risk factors for venous thromboembolism (VTE) [1], and up to 20% of patients with active cancer will develop VTE, depending on the cancer type, stage and treatment [2, 3]. Cancer-associated thrombosis (CAT) has a significant impact on prognosis and patients’ quality of life (QoL).…”

“…Cancer-associated thrombosis (CAT) has a significant impact on prognosis and patients’ quality of life (QoL). CAT is a leading cause of death among patients with cancer [4]; survivors of an initial event are at higher risk of recurrent events and bleeding during anticoagulation therapy compared with patients with VTE without malignancy [3, 5]. In the CLOT, CATCH and DALTECAN studies evaluating low molecular weight heparin (LMWH) therapy for the treatment of CAT, the residual risk of a recurrent event with 6 months’ LMWH therapy was ~7–9%, and that for major bleeding was ~2–6% [6–8].…”