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Anemia and bleeding in patients receiving anticoagulant therapy for venous thromboembolism.

Fecha de publicación:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Kuperman, A
  • Bosco, LSJ
  • Lorenzo, A
  • Jose, B
  • Farge Bancel D
  • Alfonso, M
  • Lumbierres, M
  • Stemer, G
  • Monreal Bosch M
  • Braester, A
  • RIETE Investigators

Grupos

Abstract

In patients receiving anticoagulant therapy for venous thromboembolism (VTE), the important issue of anemia influence on the risk of bleeding has not been consistently studied. We used the large registry data RIETE (Registro Informatizado Enfermedad Tromboembólica) to compare the rate of major bleeding in patients receiving anticoagulant therapy for VTE according to the presence or absence of anemia at baseline. Patients with or without cancer were separately studied. Until August 2016, 63492 patients had been enrolled. Of these, 21652 (34%) had anemia and 14312 (23%) had cancer. Anemia was found in 57% of the patients with cancer and in 28% without (odds ratio 3.46; 95% CI 3.33-3.60). During the course of anticoagulant therapy, 680 patients with cancer had a major bleeding event (gastrointestinal tract 43%, intracranial 14%, hematoma 12%). Cancer patients with anemia had a higher rate of major bleeding (rate ratio [RR]: 2.52; 95% CI 2.14-2.97) and fatal bleeding (RR 2.73; 95% CI 1.95-3.86) than those without anemia. During the course of anticoagulation, 1133 patients without cancer had major bleeding (gastrointestinal tract 32%, hematoma 24%, intracranial 21%). Patients with anemia had a higher rate of major bleeding (RR 2.84; 95% CI 2.52-2.39) and fatal bleeding (RR 2.76; 95% CI 2.07-3.67) than those without. On a multivariable analysis, anemia independently predicted the risk for major bleeding in patients with and without cancer (hazard ratios: 1.66; 95% CI 1.40-1.96 and 1.95; 95% CI 1.72-2.20, respectively). During anticoagulation for VTE, both cancer- and non-cancer anemic patients had a higher risk for major bleeding than those without anemia. In anemic patients (with or without cancer), the rate of major bleeding during the course of anticoagulant therapy exceeded the rate of VTE recurrences. In patients without anemia the rate of major bleeding was lower than the rate of VTE recurrences.

Datos de la publicación

ISSN/ISSNe:
0929-5305, 1573-742X

JOURNAL OF THROMBOSIS AND THROMBOLYSIS  Kluwer Academic Publishers

Tipo:
Article
Páginas:
360-368
Factor de Impacto:
0,995 SCImago ℠
Cuartil:
Q2 SCImago ℠

Citas Recibidas en Web of Science: 10

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Keywords

  • Anemia, Anticoagulant therapy, Cancer, Major bleeding, Venous thromboembolism

Proyectos asociados

ESTUDIO RETROSPECTIVO, POSAUTORIZACIÓN DE TIPO OBSERVACIONAL (EPA-OD), MULTICÉNTRICO, EN PACIENTES CON HAP TRATADOS CON OPSUMIT® (MACITENTAN) SEGÚN PRÁCTICA CLÍNICA HABITUAL EN ESPAÑA. PRACMA.

Investigador Principal: LUIS ALMENAR BONET

ACT-MAC-2015-01 . 2015

REGISTRO GLOBAL ANTICOAGULANTE SOBRE EL TERRENO (GLOBAL ANTICOAGULANT REGISTRY IN THE FIELD) DE OBSERVACIÓN DEL TRATAMIENTO Y LOS RESULTADOS EN PACIENTES CON EPISODIOS TROMBOEMBÓLICOS VENOSOS EN CASOS REALES.

Investigador Principal: RAQUEL LÓPEZ REYES

THR-AVK-2015-01 . 2016

EXPERT, EXPOSURE REGISTRY RIOCIGUAT (REGISTRO DE EXPOSICIÓN A RIOCIGUAT) EN PACIENTES CON HIPERTENSIÓN PULMONAR.

Investigador Principal: RAQUEL LÓPEZ REYES

BAY-RIO-2015-01 . 2016

TRATAMIENTO DOMICILIARIO DE PACIENTES CON EMBOLIA PULMONAR DE BAJO RIESGO CON EL INHIBIDOR ORAL DEL FACTOR XA RIVAROXABÁN: UN ESTUDIO PROSPECTIVO DE GESTIÓN.

Investigador Principal: RAQUEL LÓPEZ REYES

CTHC002 . 2017

QUALITY OF LIFE OF PATIENTS SUFFERING PH (PAH+CTEPH) AND PATIENTS’ PERCEPTION OF THE QUALITY OF HEALTH CARE RECEIVED IN SPAIN./ CALIDAD DE VIDA EN PACIENTES CON HIPERTENSIÓN PULMONAR (HAP Y HPTEC) Y SU PERCEPCIÓN SOBRE LA CALIDAD DE LA ATENCIÓN RECIBIDA.

Investigador Principal: RAQUEL LÓPEZ REYES

MER-PAH-2017-01 . 2017

POST-AUTHORISATION SAFETY STUDY (PASS): OBSERVATIONAL COHORT STUDY OF PAH PATIENTS NEWLY TREATED WITH EITHER UPTRAVI® (SELEXIPAG) OR ANY OTHER PAH-SPECIFIC THERAPY, IN CLINICAL PRACTICE. EXPOSURE. (EUROPEAN OBSERVATIONAL STUDY OF UPTRAVI IN REAL-LIFE).

Investigador Principal: JOAQUÍN RUEDA SORIANO

ACT-UPT-2017-01 . 2018

ESTUDIO OBSERVACIONAL RETROSPECTIVO PARA DETERMINAR EL ESTADO DE RIESGO DE PACIENTES CON HIPERTENSIÓN ARTERIAL PULMONAR EN ESPAÑA. SEMÁFORO.

Investigador Principal: RAQUEL LÓPEZ REYES

ACT-HAP-2017-01 . 2018

EVOLUCION DEL TRATAMIENTO Y USO DE RECURSOS SANITARIOS DE LA HIPERTENSION ARTERIAL PULMONAR Y LA HIPERTENSION PULMONAR TROMBOEMBOLICA CRONICA-ESTUDIO EUROPEO.

Investigador Principal: DOLORES NAUFFAL MANZUR

BAY-HTP-2009-01 . 2010

ESTUDIO LONGITUDINAL PARA IDENTIFICAR CRITERIOS PREDICTIVOS DE HIPERTENSIÓN PULMONAR POSTROMBÓTICA.

Investigador Principal: RAQUEL LÓPEZ REYES

OSIRIS

ESTUDIO DE FASE 2, ALEATORIZADO, DOBLE CIEGO, CONTROLADO CON PLACEBO, DE BÚSQUEDA DE DOSIS DE GS-4997 EN PACIENTES CON HIPERTENSIÓN ARTERIAL PULMONAR.

Investigador Principal: RAQUEL LÓPEZ REYES

GS-US-357-1394

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