Articles producció científica> Medicina i Cirurgia

Thirty-day outcomes in patients with acute pulmonary embolism who discontinued anticoagulant therapy before 90 days

  • Identification data

    Identifier: imarina:5132990
    Handle: http://hdl.handle.net/20.500.11797/imarina5132990
  • Authors:

    Nieto J., Vicente J., Prieto L., Jiménez D., Bikdeli B., Rivas A., Porras J., Morales M., Bosevski M., Monreal M.
  • Others:

    Author, as appears in the article.: Nieto J., Vicente J., Prieto L., Jiménez D., Bikdeli B., Rivas A., Porras J., Morales M., Bosevski M., Monreal M.
    Department: Medicina i Cirurgia
    URV's Author/s: Porras Ledantes, Jose Antonio
    Keywords: Hashtag Etiqueta «#» @uroweb @residentesaeu @infoAeu
    Abstract: Background The contemporary natural history of patients with acute pulmonary embolism (PE) not receiving (or early discontinuing) anticoagulant therapy has not been consistently evaluated. Objective To assess the rate of the composite outcome of PE-related death, sudden death, or recurrent thromboembolism (VTE) within 30 days in all PE patients in whom anticoagulation was not administered or discontinued prematurely (<90 days of anticoagulation). Methods We used the RIETE database to assess the incidence rates (per 100 person-days) of the composite outcome within the subsequent 30 days. The risk of these events was compared to PE patients who were anticoagulated for ≥90 days. Results Of 34,447 PE recruited from 2001 to 2017, 47 (0.14%) did not receive anticoagulants and 1348 (3.91%) discontinued it before 90 days. Fatal PE developed in 25 (53%) of those without any anticoagulation and in 45 (3.33%) with premature discontinuations. Sudden death or non-fatal recurrent VTE occurred in 6 (0.45%) and 24 (1.48%) patients, respectively. The incidence of the primary outcome declined logarithmically from 6.36 per 100 patient-days in untreated patients to 0.32-0.13 in those treated for 8-90 days. During the first week of follow-up, the incidence rate was 13.9 and 0.60-0.31 per 100 patient-days, respectively. The adjusted odds of the primary outcome was 27 fold higher in untreated than in treated patients, and progressively decreased to 2.5-7 fold higher in patients treated for at least 7 days. Conclusion The incidence of the composite outcome was highest during the first week, and inversely and logarithmically correlated with the duration of anticoagulant therapy.
    Thematic Areas: Saúde coletiva Psicología Nutrição Medicina iii Medicina ii Medicina i Interdisciplinar Historia General medicine Farmacia Educação física Ciências biológicas iii Ciências biológicas ii Ciências biológicas i Ciências agrárias i Cardiology and cardiovascular medicine Cardiac & cardiovascular systems
    licence for use: https://creativecommons.org/licenses/by/3.0/es/
    ISSN: 00028703
    Author's mail: joseantonio.porras@urv.cat
    Author identifier: 0000-0001-6418-1822
    Record's date: 2023-02-22
    Papper version: info:eu-repo/semantics/acceptedVersion
    Link to the original source: https://www.sciencedirect.com/science/article/abs/pii/S0002870318302667
    Licence document URL: http://repositori.urv.cat/ca/proteccio-de-dades/
    Papper original source: American Heart Journal. 206 1-10
    APA: Nieto J., Vicente J., Prieto L., Jiménez D., Bikdeli B., Rivas A., Porras J., Morales M., Bosevski M., Monreal M. (2018). Thirty-day outcomes in patients with acute pulmonary embolism who discontinued anticoagulant therapy before 90 days. American Heart Journal, 206(), 1-10. DOI: 10.1016/j.ahj.2018.08.014
    Article's DOI: 10.1016/j.ahj.2018.08.014
    Entity: Universitat Rovira i Virgili
    Journal publication year: 2018
    Publication Type: Journal Publications
  • Keywords:

    Cardiac & Cardiovascular Systems,Cardiology and Cardiovascular Medicine
    Saúde coletiva
    Psicología
    Nutrição
    Medicina iii
    Medicina ii
    Medicina i
    Interdisciplinar
    Historia
    General medicine
    Farmacia
    Educação física
    Ciências biológicas iii
    Ciências biológicas ii
    Ciências biológicas i
    Ciências agrárias i
    Cardiology and cardiovascular medicine
    Cardiac & cardiovascular systems
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