Baseline Analysis on the Outcome of Patients with Deep Vein Thrombosis (DVT) Before the Global Impact of New Oral Anticoagulants in Italy: Data from RIETE Registry
- *Corresponding Author:
- Pierpaolo Di Micco
Fatebenefratelli Hospital of Naples, Italy
Tel: 393398 078146
E-mail: [email protected]
Received Date: October 09, 2014; Accepted Date: November 19, 2014; Published Date: November 21, 2014
Citation: Micco PD, Visonà A, Micco GD, Guida A, Jimenez D, et al. (2014) Baseline Analysis on the Outcome of Patients with Deep Vein Thrombosis (DVT) Before the Global Impact of New Oral Anticoagulants in Italy: Data from RIETE Registry. J Blood Lymph 4:129. doi: 10.4172/2165-7831.1000129
Copyright: © 2014 Di Micco P et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: In patients with venous thromboembolism (VTE), assessment of the risk of recurrent VTE and major bleeding may help to guide intensity and duration of anticoagulant therapy. Methods: We used the Registro Informatizado de Enfermedad Tromboemb?lica (RIETE) to identify predictors of poor adherence to guidelines in patients with- and without cancer, and to assess the rate and severity of VTE recurrences and major bleeding during the course of anticoagulation in Italian patients with deep vein thrombosis (DVT). Results: A total of 3541 patients with objectively diagnosed VTE were enrolled in Italy, of whom 1832 (52%) initially presented DVT. Of these, 409 (22%) patients had already known cancer at baseline. In all, 32% of patients with cancer and 74% of those without cancer received long-term therapy with vitamin K antagonists, 55% and 19% respectively received long-term therapy with low-molecular-weight heparin, and 11% and 5.3% respectively received long-term therapy with Fondaparinux. During the 3-month study period, DVT patients with cancer experienced an increased rate of DVT recurrences (odds ratio: 3.1; 95% CI: 1.2-8.2), major bleeding episodes (odds ratio: 4.3; 95% CI: 2.2-8.4), all-cause death (odds ratio: 11; 95% CI: 6.7-19), and fatal bleeding (odds ratio: 11; 95% CI: 1.1-101), compared with those without cancer. Interestingly, the rate of major bleeding events outweighed the rate of VTE recurrences, both in patients with cancer (19 major bleeds vs. 4 PE recurrences and 8 DVT recurrences) and in those without cancer (16 major bleeds vs. 5 PE recurrences and 9 DVT recurrences). Conclusions: In real life, adherence of VTE therapy to guidelines is poor. During the course of anticoagulation, the rate of major bleeding events exceeded the rate of VTE recurrences.