Venous thromboembolism in young adults: Findings from the RIETE registry.
Por:
Lacruz B, Tiberio G, Latorre A, Villalba JC, Bikdeli B, Hirmerova J, Lorenzo A, Mellado M, Cañas I, Monreal M and RIETE Investigators
Publicada:
1 may 2019
Ahead of Print:
11 mar 2019
Resumen:
BACKGROUND: Little is known on the clinical characteristics, risk factors and outcomes during anticoagulation in young patients with acute venous thromboembolism (VTE). METHODS: We used data from the RIETE (Registro Informatizado Enfermedad TromboEmbólica) registry to assess the clinical characteristics, risk factors and outcomes during anticoagulation in VTE patients aged 10-24?years. Data were separately analyzed according to initial presentation and gender. RESULTS: Of 76,719 patients with VTE, 1571 (2.0%) were aged 10-24?years. Of these, 989 (63%) were women and 669 (43%) presented with pulmonary embolism (PE). Most women were using estrogens (680, 69%) or were pregnant (101, 10%), while 59% of men had unprovoked VTE. Women were more likely to present with PE (48% vs. 34%). The majority (87%) of PE patients had Sat O(2) levels =90% at baseline. The vast majority (97%) of PE patients were at low risk according to the PESI score, many (90%) at very low risk. During the course of anticoagulation (median, 192?days), 40 patients had VTE recurrences, 17 had major bleeding and 10 died (3 died of PE). Women had as many VTE recurrences as major bleeds (15 vs. 14 events), while men had many more VTE recurrences than major bleeding (25 vs. 3 events). CONCLUSIONS: VTE is associated with low risk of short-term mortality in young adults. Noticeable gender differences exist in the risk factor profile and the risk of VTE recurrences and major bleeding in the course of anticoagulation.
Filiaciones:
Lacruz B:
Department of Internal Medicine, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
Tiberio G:
Department of Internal Medicine, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
Latorre A:
Department of Internal Medicine, Complexo Hospitalario Universitario de Ourense, Spain
Villalba JC:
Intensive Care Unit, Hospital Universitario Germans Trias i Pujol de Badalona, Barcelona, Spain
Bikdeli B:
Division of Cardiology, Department of Medicine, Columbia University Medical Center/New York-Presbyterian Hospital, New York, NY, USA
Center for Outcomes Research and Evaluation (CORE), Yale School of Medicine, New Haven, CT, USA
Cardiovascular Research Foundation (CRF), New York, NY, USA
Hirmerova J:
Department of Internal Medicine, University Hospital Plzen, Plzen, Czech Republic
Lorenzo A:
Department of Internal Medicine, Hospital Universitario La Paz, Madrid, Spain
Mellado M:
Department of Angiology and Vascular Surgery, Hospital del Mar. Barcelona, Spain
Cañas I:
Department of Internal Medicine, Hospital General de Granollers, Barcelona, Spain
Monreal M:
Department of Internal Medicine, Hospital Universitario Germans Trias i Pujol de Badalona. Barcelona, Universidad Autónoma de Barcelona, Spain
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