alexa 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 | Abstract
ISSN: 2165-7831

Journal of Blood & Lymph
Open Access

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Research Article

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

Pierpaolo Di Micco1*, Adriana Visonà2, Gianluca Di Micco3, Anna Guida4, David Jimenez5, Paolo Prandoni6, Iolanda Enea7, Alferio Niglio8, Laurent Bertoletti9 and Manuel Monreal10

1Emergency Room, Fatebenefratelli Hospital of Naples, Italy

2Department of Angiology, Castelfranco Veneto, Italy

3Division of Cardiology, Fatebenefratelli Hospital of Naples, Italy

4Dipartimento Area Critica AOU S. Giovanni e Ruggi, Salerno, Italy

5Department of Pneumology, Hospital Universitario Ramon y Cajal, Madrid, Spain

6Clinica Medica, University of Padua, Italy

7Emergency Medicine, Ospedale Civile di Caserta, Italy

8Internal Medicine, Second University of Naples, Italy

9Thrombosis Research Group, EA3065, University Saint-Etienne, Jean Monnet, Saint-Etienne F-42023, France

10Servicio de Medicina Interna, Hopital Universitari Germans Trias y Pujol, Badalona, Spain

*Corresponding Author:
Pierpaolo Di Micco
Emergency Room
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.

Abstract

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.

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