Outcomes during anticoagulation in patients with symptomatic vs. incidental splanchnic vein thrombosis
Current guidelines recommend the use of anticoagulant therapy in patients with symptomatic splanchnic vein thrombosis (SVT) and suggest no routine anticoagulation in those with incidental SVT. We used the RIETE (Registro Informatizado Enfermedad Trombo Embólica) registry to assess the rate and sever...
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| Veröffentlicht in: | Thrombosis research 2018-04, Vol.164, p.69-74 |
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| creator | Tufano, Antonella Ageno, Walter Di Micco, Pierpaolo Niglio, Alferio Rosa, Vladimir Ballaz, Aitor Braester, Andrei Rubio, Carmen Mª. Isern, Virginia Imbalzano, Egidio Monreal, Manuel |
| description | Current guidelines recommend the use of anticoagulant therapy in patients with symptomatic splanchnic vein thrombosis (SVT) and suggest no routine anticoagulation in those with incidental SVT.
We used the RIETE (Registro Informatizado Enfermedad Trombo Embólica) registry to assess the rate and severity of symptomatic venous thromboembolism (VTE) recurrences and major bleeding events appearing during the course of anticoagulation in patients with symptomatic or incidental SVT.
In March 2017, 521 patients with SVT were recruited. Of them, 212 (41%) presented with symptomatic SVT and 309 had incidental SVT. Most (93%) patients received anticoagulant therapy (median, 147 days). During the course of anticoagulation, 20 patients developed symptomatic VTE recurrences (none died) and 26 had major bleeding (fatal bleeding, 5). On multivariable analysis, patients with incidental SVT had a non-significantly higher risk for symptomatic VTE recurrences (adjusted hazard ratio [HR]: 2.04; 95%CI: 0.71–5.88) and a similar risk for major bleeding (HR: 1.12; 95%CI: 0.47–2.63) than those with symptomatic SVT. Active cancer was associated with at increased risk for VTE recurrences (HR: 3.06; 95%CI: 1.14–8.17) and anaemia (HR: 4.11; 95%CI: 1.45–11.6) or abnormal prothrombin time (HR: 4.10; 95%CI: 1.68–10.1) were associated with at increased risk for major bleeding.
The rates of recurrent SVT and major bleeding were similar between patients with incidental or symptomatic SVT. Because the severity of bleeding complications during anticoagulation may outweigh the severity of VTE recurrences in both groups, further studies should identify those SVT patients who benefit from anticoagulant therapy.
•Current guidelines recommend to anticoagulate SVT only if symptomatic.•We assessed the rate and severity of VTE recurrences and major bleeding during therapy.•During anticoagulation, the severity of bleeding may outweigh the severity of recurrences.•Further studies should identify what SVT patients may benefit from anticoagulation. |
| doi_str_mv | 10.1016/j.thromres.2018.02.143 |
| format | Article |
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We used the RIETE (Registro Informatizado Enfermedad Trombo Embólica) registry to assess the rate and severity of symptomatic venous thromboembolism (VTE) recurrences and major bleeding events appearing during the course of anticoagulation in patients with symptomatic or incidental SVT.
In March 2017, 521 patients with SVT were recruited. Of them, 212 (41%) presented with symptomatic SVT and 309 had incidental SVT. Most (93%) patients received anticoagulant therapy (median, 147 days). During the course of anticoagulation, 20 patients developed symptomatic VTE recurrences (none died) and 26 had major bleeding (fatal bleeding, 5). On multivariable analysis, patients with incidental SVT had a non-significantly higher risk for symptomatic VTE recurrences (adjusted hazard ratio [HR]: 2.04; 95%CI: 0.71–5.88) and a similar risk for major bleeding (HR: 1.12; 95%CI: 0.47–2.63) than those with symptomatic SVT. Active cancer was associated with at increased risk for VTE recurrences (HR: 3.06; 95%CI: 1.14–8.17) and anaemia (HR: 4.11; 95%CI: 1.45–11.6) or abnormal prothrombin time (HR: 4.10; 95%CI: 1.68–10.1) were associated with at increased risk for major bleeding.
The rates of recurrent SVT and major bleeding were similar between patients with incidental or symptomatic SVT. Because the severity of bleeding complications during anticoagulation may outweigh the severity of VTE recurrences in both groups, further studies should identify those SVT patients who benefit from anticoagulant therapy.
•Current guidelines recommend to anticoagulate SVT only if symptomatic.•We assessed the rate and severity of VTE recurrences and major bleeding during therapy.•During anticoagulation, the severity of bleeding may outweigh the severity of recurrences.•Further studies should identify what SVT patients may benefit from anticoagulation.</description><identifier>ISSN: 0049-3848</identifier><identifier>EISSN: 1879-2472</identifier><identifier>DOI: 10.1016/j.thromres.2018.02.143</identifier><identifier>PMID: 29499439</identifier><language>eng</language><publisher>United States: Elsevier Ltd</publisher><subject>Anticoagulant therapy ; Bleeding ; Recurrences ; Splanchnic vein thrombosis</subject><ispartof>Thrombosis research, 2018-04, Vol.164, p.69-74</ispartof><rights>2018 Elsevier Ltd</rights><rights>Copyright © 2018 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c368t-eace3a161437cac5c0a35c7513ed472a002d4f7014433748b252809408efd86d3</citedby><cites>FETCH-LOGICAL-c368t-eace3a161437cac5c0a35c7513ed472a002d4f7014433748b252809408efd86d3</cites><orcidid>0000-0003-2398-6135</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0049384818302159$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29499439$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tufano, Antonella</creatorcontrib><creatorcontrib>Ageno, Walter</creatorcontrib><creatorcontrib>Di Micco, Pierpaolo</creatorcontrib><creatorcontrib>Niglio, Alferio</creatorcontrib><creatorcontrib>Rosa, Vladimir</creatorcontrib><creatorcontrib>Ballaz, Aitor</creatorcontrib><creatorcontrib>Braester, Andrei</creatorcontrib><creatorcontrib>Rubio, Carmen Mª.</creatorcontrib><creatorcontrib>Isern, Virginia</creatorcontrib><creatorcontrib>Imbalzano, Egidio</creatorcontrib><creatorcontrib>Monreal, Manuel</creatorcontrib><creatorcontrib>the RIETE Investigators</creatorcontrib><creatorcontrib>RIETE Investigators</creatorcontrib><title>Outcomes during anticoagulation in patients with symptomatic vs. incidental splanchnic vein thrombosis</title><title>Thrombosis research</title><addtitle>Thromb Res</addtitle><description>Current guidelines recommend the use of anticoagulant therapy in patients with symptomatic splanchnic vein thrombosis (SVT) and suggest no routine anticoagulation in those with incidental SVT.
We used the RIETE (Registro Informatizado Enfermedad Trombo Embólica) registry to assess the rate and severity of symptomatic venous thromboembolism (VTE) recurrences and major bleeding events appearing during the course of anticoagulation in patients with symptomatic or incidental SVT.
In March 2017, 521 patients with SVT were recruited. Of them, 212 (41%) presented with symptomatic SVT and 309 had incidental SVT. Most (93%) patients received anticoagulant therapy (median, 147 days). During the course of anticoagulation, 20 patients developed symptomatic VTE recurrences (none died) and 26 had major bleeding (fatal bleeding, 5). On multivariable analysis, patients with incidental SVT had a non-significantly higher risk for symptomatic VTE recurrences (adjusted hazard ratio [HR]: 2.04; 95%CI: 0.71–5.88) and a similar risk for major bleeding (HR: 1.12; 95%CI: 0.47–2.63) than those with symptomatic SVT. Active cancer was associated with at increased risk for VTE recurrences (HR: 3.06; 95%CI: 1.14–8.17) and anaemia (HR: 4.11; 95%CI: 1.45–11.6) or abnormal prothrombin time (HR: 4.10; 95%CI: 1.68–10.1) were associated with at increased risk for major bleeding.
The rates of recurrent SVT and major bleeding were similar between patients with incidental or symptomatic SVT. Because the severity of bleeding complications during anticoagulation may outweigh the severity of VTE recurrences in both groups, further studies should identify those SVT patients who benefit from anticoagulant therapy.
•Current guidelines recommend to anticoagulate SVT only if symptomatic.•We assessed the rate and severity of VTE recurrences and major bleeding during therapy.•During anticoagulation, the severity of bleeding may outweigh the severity of recurrences.•Further studies should identify what SVT patients may benefit from anticoagulation.</description><subject>Anticoagulant therapy</subject><subject>Bleeding</subject><subject>Recurrences</subject><subject>Splanchnic vein thrombosis</subject><issn>0049-3848</issn><issn>1879-2472</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNqFkM1u3CAUhVGVqpmkfYXIy27sXn5sw65VlLSVRsqmXSMGrjOMbOMCTpS3D5NJsu0KxD2He85HyBWFhgLtvh2avI9hipgaBlQ2wBoq-AeyobJXNRM9OyMbAKFqLoU8JxcpHQBoT1X7iZwzJZQSXG3IcLdmGyZMlVujn-8rM2dvg7lfR5N9mCs_V0u54ZxT9ejzvkpP05LDVN5s9ZCaIrDelbEZq7SMZrb7-TjBYnyJuAvJp8_k42DGhF9ez0vy9_bmz_Wvenv38_f1j21teSdzjcYiN7QrVXprbGvB8Nb2LeXoSiUDwJwYeqBCcN4LuWMtk6AESByc7By_JF9P_y4x_FsxZT35ZHEsuTCsSRdWwHvFpSrS7iS1MaQUcdBL9JOJT5qCPjLWB_3G-OiTGpguwYrx6nXHupvQvdveoBbB95MAS9MHj1EnWwBadD6izdoF_78dzxGQk0M</recordid><startdate>201804</startdate><enddate>201804</enddate><creator>Tufano, Antonella</creator><creator>Ageno, Walter</creator><creator>Di Micco, Pierpaolo</creator><creator>Niglio, Alferio</creator><creator>Rosa, Vladimir</creator><creator>Ballaz, Aitor</creator><creator>Braester, Andrei</creator><creator>Rubio, Carmen Mª.</creator><creator>Isern, Virginia</creator><creator>Imbalzano, Egidio</creator><creator>Monreal, Manuel</creator><general>Elsevier Ltd</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-2398-6135</orcidid></search><sort><creationdate>201804</creationdate><title>Outcomes during anticoagulation in patients with symptomatic vs. incidental splanchnic vein thrombosis</title><author>Tufano, Antonella ; Ageno, Walter ; Di Micco, Pierpaolo ; Niglio, Alferio ; Rosa, Vladimir ; Ballaz, Aitor ; Braester, Andrei ; Rubio, Carmen Mª. ; Isern, Virginia ; Imbalzano, Egidio ; Monreal, Manuel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c368t-eace3a161437cac5c0a35c7513ed472a002d4f7014433748b252809408efd86d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Anticoagulant therapy</topic><topic>Bleeding</topic><topic>Recurrences</topic><topic>Splanchnic vein thrombosis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tufano, Antonella</creatorcontrib><creatorcontrib>Ageno, Walter</creatorcontrib><creatorcontrib>Di Micco, Pierpaolo</creatorcontrib><creatorcontrib>Niglio, Alferio</creatorcontrib><creatorcontrib>Rosa, Vladimir</creatorcontrib><creatorcontrib>Ballaz, Aitor</creatorcontrib><creatorcontrib>Braester, Andrei</creatorcontrib><creatorcontrib>Rubio, Carmen Mª.</creatorcontrib><creatorcontrib>Isern, Virginia</creatorcontrib><creatorcontrib>Imbalzano, Egidio</creatorcontrib><creatorcontrib>Monreal, Manuel</creatorcontrib><creatorcontrib>the RIETE Investigators</creatorcontrib><creatorcontrib>RIETE Investigators</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Thrombosis research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tufano, Antonella</au><au>Ageno, Walter</au><au>Di Micco, Pierpaolo</au><au>Niglio, Alferio</au><au>Rosa, Vladimir</au><au>Ballaz, Aitor</au><au>Braester, Andrei</au><au>Rubio, Carmen Mª.</au><au>Isern, Virginia</au><au>Imbalzano, Egidio</au><au>Monreal, Manuel</au><aucorp>the RIETE Investigators</aucorp><aucorp>RIETE Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes during anticoagulation in patients with symptomatic vs. incidental splanchnic vein thrombosis</atitle><jtitle>Thrombosis research</jtitle><addtitle>Thromb Res</addtitle><date>2018-04</date><risdate>2018</risdate><volume>164</volume><spage>69</spage><epage>74</epage><pages>69-74</pages><issn>0049-3848</issn><eissn>1879-2472</eissn><abstract>Current guidelines recommend the use of anticoagulant therapy in patients with symptomatic splanchnic vein thrombosis (SVT) and suggest no routine anticoagulation in those with incidental SVT.
We used the RIETE (Registro Informatizado Enfermedad Trombo Embólica) registry to assess the rate and severity of symptomatic venous thromboembolism (VTE) recurrences and major bleeding events appearing during the course of anticoagulation in patients with symptomatic or incidental SVT.
In March 2017, 521 patients with SVT were recruited. Of them, 212 (41%) presented with symptomatic SVT and 309 had incidental SVT. Most (93%) patients received anticoagulant therapy (median, 147 days). During the course of anticoagulation, 20 patients developed symptomatic VTE recurrences (none died) and 26 had major bleeding (fatal bleeding, 5). On multivariable analysis, patients with incidental SVT had a non-significantly higher risk for symptomatic VTE recurrences (adjusted hazard ratio [HR]: 2.04; 95%CI: 0.71–5.88) and a similar risk for major bleeding (HR: 1.12; 95%CI: 0.47–2.63) than those with symptomatic SVT. Active cancer was associated with at increased risk for VTE recurrences (HR: 3.06; 95%CI: 1.14–8.17) and anaemia (HR: 4.11; 95%CI: 1.45–11.6) or abnormal prothrombin time (HR: 4.10; 95%CI: 1.68–10.1) were associated with at increased risk for major bleeding.
The rates of recurrent SVT and major bleeding were similar between patients with incidental or symptomatic SVT. Because the severity of bleeding complications during anticoagulation may outweigh the severity of VTE recurrences in both groups, further studies should identify those SVT patients who benefit from anticoagulant therapy.
•Current guidelines recommend to anticoagulate SVT only if symptomatic.•We assessed the rate and severity of VTE recurrences and major bleeding during therapy.•During anticoagulation, the severity of bleeding may outweigh the severity of recurrences.•Further studies should identify what SVT patients may benefit from anticoagulation.</abstract><cop>United States</cop><pub>Elsevier Ltd</pub><pmid>29499439</pmid><doi>10.1016/j.thromres.2018.02.143</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0003-2398-6135</orcidid></addata></record> |
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| subjects | Anticoagulant therapy Bleeding Recurrences Splanchnic vein thrombosis |
| title | Outcomes during anticoagulation in patients with symptomatic vs. incidental splanchnic vein thrombosis |
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