Articles producció científica> Medicina i Cirurgia

Venous thromboembolism characteristics and outcomes among RIETE patients tested and untested for inherited thrombophilia

  • Identification data

    Identifier: imarina:9442995
    Handle: https://hdl.handle.net/20.500.11797/imarina9442995
    Authors:
    Cohen ORadinsky LWKenet GMahé IBarillari GSoler SSigüenza PDel Valle Morales MVillares PMonreal MMonreal MPrandoni PBrenner BFarge-Bancel DBarba RDi Micco PBertoletti LSchellong STzoran IReis ABosevski MBounameaux HMalý RVerhamme PCaprini JAMy Bui HAdarraga MDAlberich-Conesa AAibar JAlda-Lozano AAlfonso JAmado CAngelina-García MArcelus JIBallaz ABarba RBarbagelata CBarrón MBarrón-Andrés BBeddar-Chaib FBlanco-Molina ACaballero JCCastellanos GCriado JDe Ancos CDel Toro JDemelo-Rodríguez PDe Juana-Izquierdo CDíaz-Peromingo JADubois-Silva AEscribano JCFalgá CFarfán-Sedano AIFernández-Aracil CFernández-Capitán CFernández-Jiménez BFernández-Reyes JLFidalgo MAFrancisco IGabara CGaleano-Valle FGarcía-Bragado FGarcía-Ortega AGavín-Sebastián OGil-Díaz AGómez-Cuervo CGonzález-García CGonzález-Munera AGrau EGuirado LGutiérrez-Guisado JHernández-Blasco LHerreros MJara-Palomares LJaras MJJiménez DJou IJoya MDLecumberri RLlamas PLobo JLLópez-Jiménez LLópez-Miguel PLópez-Brull HLópez-Núñez JJLópez-Ruiz ALópez-Sáez JBLorenzo ALumbierres MMadridano OMaestre AMarchena PJMarcos Mdel Pozo MMMartín-Martos FMartínez-Prado RMaza JMMena EMercado MIMoisés J
    Abstract:
    Inherited thrombophilia (IT) workup is commonly pursued in patients with venous thromboembolism (VTE). Recent American Society of Hematology guidelines recommend a selective approach to IT testing, nevertheless, evidence on whether thrombophilia testing can actually improve patient-important outcomes through tailored management is limited. Data from the large, prospective Registro Informatizado de Enfermedad TromboEmbólica (RIETE) registry were analyzed to compare VTE risk factors, management, and outcomes between patients who were tested for IT and untested patients, during anticoagulant treatment and after its discontinuation. Among 103 818 patients enrolled in RIETE, 21 089 (20.3%) were tested for IT, 8422 (8.1%) tested positive, and 82 729 (79.7%) were not tested. IT testing was more frequent in patients with VTE provoked by minor risk factors and less common in those with major risk factors such as surgery or active cancer. Choices of anticoagulant treatment did not differ based on IT testing results. Untested patients exhibited inferior outcomes across all VTE categories, with higher rates of VTE recurrence, major bleeding, mortality, and notably, cancer-related mortality. After treatment discontinuation, IT-negative patients with surgically provoked VTE showed lower recurrence rates. For immobilization-related VTE as well as in estrogen-related VTE, no significant differences in recurrence rates were observed between IT-negative and IT-positive patients. However, IT-negative patients with pregnancy or postpartum-related VTE had significantly lower recurrence rates. Patients with unprovoked VTE, particularly those testing positive for IT, had high recurrence rates after treatment. These findings underscore the complex role of IT testing in managing VTE, supporting

  • Others:

    Author, as appears in the article.: Cohen O; Radinsky LW; Kenet G; Mahé I; Barillari G; Soler S; Sigüenza P; Del Valle Morales M; Villares P; Monreal M; Monreal M; Prandoni P; Brenner B; Farge-Bancel D; Barba R; Di Micco P; Bertoletti L; Schellong S; Tzoran I; Reis A; Bosevski M; Bounameaux H; Malý R; Verhamme P; Caprini JA; My Bui H; Adarraga MD; Alberich-Conesa A; Aibar J; Alda-Lozano A; Alfonso J; Amado C; Angelina-García M; Arcelus JI; Ballaz A; Barba R; Barbagelata C; Barrón M; Barrón-Andrés B; Beddar-Chaib F; Blanco-Molina A; Caballero JC; Castellanos G; Criado J; De Ancos C; Del Toro J; Demelo-Rodríguez P; De Juana-Izquierdo C; Díaz-Peromingo JA; Dubois-Silva A; Escribano JC; Falgá C; Farfán-Sedano AI; Fernández-Aracil C; Fernández-Capitán C; Fernández-Jiménez B; Fernández-Reyes JL; Fidalgo MA; Francisco I; Gabara C; Galeano-Valle F; García-Bragado F; García-Ortega A; Gavín-Sebastián O; Gil-Díaz A; Gómez-Cuervo C; González-García C; González-Munera A; Grau E; Guirado L; Gutiérrez-Guisado J; Hernández-Blasco L; Herreros M; Jara-Palomares L; Jaras MJ; Jiménez D; Jou I; Joya MD; Lecumberri R; Llamas P; Lobo JL; López-Jiménez L; López-Miguel P; López-Brull H; López-Núñez JJ; López-Ruiz A; López-Sáez JB; Lorenzo A; Lumbierres M; Madridano O; Maestre A; Marchena PJ; Marcos M; del Pozo MM; Martín-Martos F; Martínez-Prado R; Maza JM; Mena E; Mercado MI; Moisés J
    Department: Medicina i Cirurgia
    URV's Author/s: Porras Ledantes, Jose Antonio
    Keywords: Good health and well-being
    Abstract: Inherited thrombophilia (IT) workup is commonly pursued in patients with venous thromboembolism (VTE). Recent American Society of Hematology guidelines recommend a selective approach to IT testing, nevertheless, evidence on whether thrombophilia testing can actually improve patient-important outcomes through tailored management is limited. Data from the large, prospective Registro Informatizado de Enfermedad TromboEmbólica (RIETE) registry were analyzed to compare VTE risk factors, management, and outcomes between patients who were tested for IT and untested patients, during anticoagulant treatment and after its discontinuation. Among 103 818 patients enrolled in RIETE, 21 089 (20.3%) were tested for IT, 8422 (8.1%) tested positive, and 82 729 (79.7%) were not tested. IT testing was more frequent in patients with VTE provoked by minor risk factors and less common in those with major risk factors such as surgery or active cancer. Choices of anticoagulant treatment did not differ based on IT testing results. Untested patients exhibited inferior outcomes across all VTE categories, with higher rates of VTE recurrence, major bleeding, mortality, and notably, cancer-related mortality. After treatment discontinuation, IT-negative patients with surgically provoked VTE showed lower recurrence rates. For immobilization-related VTE as well as in estrogen-related VTE, no significant differences in recurrence rates were observed between IT-negative and IT-positive patients. However, IT-negative patients with pregnancy or postpartum-related VTE had significantly lower recurrence rates. Patients with unprovoked VTE, particularly those testing positive for IT, had high recurrence rates after treatment. These findings underscore the complex role of IT testing in managing VTE, supporting personalized treatment strategies that consider VTE risk factors and comorbidities. The trial was registered at www.clinicaltrials.gov as #NCT02832245.
    Thematic Areas: Hematology
    licence for use: https://creativecommons.org/licenses/by/3.0/es/
    Author's mail: joseantonio.porras@urv.cat
    Author identifier: 0000-0001-6418-1822
    Record's date: 2025-03-03
    Paper version: info:eu-repo/semantics/publishedVersion
    Paper original source: Blood Advances. 8 (18): 4950-4959
    APA: Cohen O; Radinsky LW; Kenet G; Mahé I; Barillari G; Soler S; Sigüenza P; Del Valle Morales M; Villares P; Monreal M; Monreal M; Prandoni P; Brenner B; (2024). Venous thromboembolism characteristics and outcomes among RIETE patients tested and untested for inherited thrombophilia. Blood Advances, 8(18), 4950-4959. DOI: 10.1182/bloodadvances.2024012611
    Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
    Entity: Universitat Rovira i Virgili
    Journal publication year: 2024
    Publication Type: Journal Publications

  • Keywords:

    Hematology
    Good health and well-being
    Hematology

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