Loading…
Index clinical manifestation of venous thromboembolism predicts early recurrence type and frequency: a meta‐analysis of randomized controlled trials
Summary Background Observational studies suggest index clinical manifestation of venous thromboembolism (VTE) predicts recurrence type. Data regarding the association between index manifestation and recurrence rates are conflicting. Objectives To perform a meta‐analysis of randomized controlled tria...
Saved in:
| Published in: | Journal of thrombosis and haemostasis 2015-06, Vol.13 (6), p.1043-1052 |
|---|---|
| Main Authors: | , , , , , , , |
| Format: | Article |
| Language: | English |
| Subjects: | |
| Citations: | Items that this one cites Items that cite this one |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| cited_by | cdi_FETCH-LOGICAL-c4894-317a974e98552e2c97a1fe7d0572036fd3189ad93bafb71fc92ea9f36c134cc13 |
|---|---|
| cites | cdi_FETCH-LOGICAL-c4894-317a974e98552e2c97a1fe7d0572036fd3189ad93bafb71fc92ea9f36c134cc13 |
| container_end_page | 1052 |
| container_issue | 6 |
| container_start_page | 1043 |
| container_title | Journal of thrombosis and haemostasis |
| container_volume | 13 |
| creator | Mearns, E. S. Coleman, C. I. Patel, D. Saulsberry, W. J. Corman, A. Li, D. Hernandez, A. V. Kohn, C. G. |
| description | Summary
Background
Observational studies suggest index clinical manifestation of venous thromboembolism (VTE) predicts recurrence type. Data regarding the association between index manifestation and recurrence rates are conflicting.
Objectives
To perform a meta‐analysis of randomized controlled trials (RCTs) to determine the type and frequency of recurrent VTE (rVTE) in persons after an index deep vein thrombosis (DVT) or pulmonary embolism (PE).
Patients/Methods
We searched bibliographic databases for RCTs of acute (early) treatment of rVTE in persons with an index DVT or PE (±DVT), enrolling ≥ 50 subjects anticoagulated ≥ 3‐months and reporting types of rVTE. We pooled (random‐effects) the proportion of rVTEs that were DVTs, PEs, and fatal PEs, the proportion of recurrent PEs that were fatal, and absolute rVTE rates.
Results
In nine RCTs (N = 13 640; 413 rVTEs) evaluating persons with an index PE; 66% (95% CI, 60–72%) of rVTEs were PE and 27% (95% CI, 22–33%) were fatal PE. Among 25 RCTs (N = 17 340; 692 rVTEs) evaluating persons with an index DVT, 36% (95% CI, 29–44%) experienced a recurrent PE and 10% (95% CI, 7–13%) a fatal PE. Recurrent PEs following an index PE had a higher fatality rate than after an index DVT (41%; 95% CI, 33–48% vs. 25%; 95% CI, 18–33%; P = 0.007). The rVTE rate was higher following an index DVT compared with a PE (2.6%; 95% CI, 1.6–3.8% vs. 4.9%; 95% CI, 4.0–6.0%; P = 0.002).
Conclusions
Our meta‐analysis suggests most rVTEs will be the same type as the index event. While index DVTs are associated with a higher rVTE rate than index PEs; recurrent PEs are associated with high fatality. |
| doi_str_mv | 10.1111/jth.12914 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_1684452664</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3700990091</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4894-317a974e98552e2c97a1fe7d0572036fd3189ad93bafb71fc92ea9f36c134cc13</originalsourceid><addsrcrecordid>eNp1kUtOBCEQhonROONj4QUMiSsXow30C3fG-MwkbnTdYegiMqFhBFptVx7BlQf0JKIzupMEqkK-fKnUj9AeyY5IOsfz-HBEKCf5GhqTgtWTqmbl-m_PGRuhrRDmWUZ4QbNNNKJFTTin2Rh9XNsWXrA02mopDO6E1QpCFFE7i53CT2BdH3B88K6bOUjX6NDhhYdWyxgwCG8G7EH23oOVgOOwACxsi5WHxz59DSdY4A6i-Hx7F1aYIejwbfYJcp1-hRZLZ6N3xqQ2ei1M2EEbKhXYXdVtdH9xfnd2NZneXl6fnU4nMq95PmGkErzKgddFQYFKXgmioGqzoqIZK1XLSM1Fy9lMqFlFlOQUBFeslITlMj3b6GDpXXiXhg2xmbvepyFDQ8o6zwtalnmiDpeU9C4ED6pZeN0JPzQka74TaFICzU8Cid1fGftZB-0f-bvyBBwvgWdtYPjf1NzcXS2VX_E-lMA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1684452664</pqid></control><display><type>article</type><title>Index clinical manifestation of venous thromboembolism predicts early recurrence type and frequency: a meta‐analysis of randomized controlled trials</title><source>Wiley</source><source>Free E-Journal (出版社公開部分のみ）</source><creator>Mearns, E. S. ; Coleman, C. I. ; Patel, D. ; Saulsberry, W. J. ; Corman, A. ; Li, D. ; Hernandez, A. V. ; Kohn, C. G.</creator><creatorcontrib>Mearns, E. S. ; Coleman, C. I. ; Patel, D. ; Saulsberry, W. J. ; Corman, A. ; Li, D. ; Hernandez, A. V. ; Kohn, C. G.</creatorcontrib><description>Summary
Background
Observational studies suggest index clinical manifestation of venous thromboembolism (VTE) predicts recurrence type. Data regarding the association between index manifestation and recurrence rates are conflicting.
Objectives
To perform a meta‐analysis of randomized controlled trials (RCTs) to determine the type and frequency of recurrent VTE (rVTE) in persons after an index deep vein thrombosis (DVT) or pulmonary embolism (PE).
Patients/Methods
We searched bibliographic databases for RCTs of acute (early) treatment of rVTE in persons with an index DVT or PE (±DVT), enrolling ≥ 50 subjects anticoagulated ≥ 3‐months and reporting types of rVTE. We pooled (random‐effects) the proportion of rVTEs that were DVTs, PEs, and fatal PEs, the proportion of recurrent PEs that were fatal, and absolute rVTE rates.
Results
In nine RCTs (N = 13 640; 413 rVTEs) evaluating persons with an index PE; 66% (95% CI, 60–72%) of rVTEs were PE and 27% (95% CI, 22–33%) were fatal PE. Among 25 RCTs (N = 17 340; 692 rVTEs) evaluating persons with an index DVT, 36% (95% CI, 29–44%) experienced a recurrent PE and 10% (95% CI, 7–13%) a fatal PE. Recurrent PEs following an index PE had a higher fatality rate than after an index DVT (41%; 95% CI, 33–48% vs. 25%; 95% CI, 18–33%; P = 0.007). The rVTE rate was higher following an index DVT compared with a PE (2.6%; 95% CI, 1.6–3.8% vs. 4.9%; 95% CI, 4.0–6.0%; P = 0.002).
Conclusions
Our meta‐analysis suggests most rVTEs will be the same type as the index event. While index DVTs are associated with a higher rVTE rate than index PEs; recurrent PEs are associated with high fatality.</description><identifier>ISSN: 1538-7933</identifier><identifier>ISSN: 1538-7836</identifier><identifier>EISSN: 1538-7836</identifier><identifier>DOI: 10.1111/jth.12914</identifier><identifier>PMID: 25819920</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Anticoagulants - therapeutic use ; Bibliographic data bases ; Clinical trials ; deep vein thrombosis ; Humans ; Medical treatment ; meta‐analysis ; Predictive Value of Tests ; pulmonary embolism ; Pulmonary Embolism - diagnosis ; Pulmonary Embolism - drug therapy ; Pulmonary Embolism - mortality ; Randomized Controlled Trials as Topic ; Recurrence ; Risk Assessment ; Risk Factors ; Time Factors ; Treatment Outcome ; venous thromboembolism ; Venous Thromboembolism - diagnosis ; Venous Thromboembolism - drug therapy ; Venous Thromboembolism - mortality ; venous thrombosis ; Venous Thrombosis - diagnosis ; Venous Thrombosis - drug therapy ; Venous Thrombosis - mortality</subject><ispartof>Journal of thrombosis and haemostasis, 2015-06, Vol.13 (6), p.1043-1052</ispartof><rights>2015 International Society on Thrombosis and Haemostasis</rights><rights>2015 International Society on Thrombosis and Haemostasis.</rights><rights>Copyright © 2015 International Society on Thrombosis and Haemostasis</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4894-317a974e98552e2c97a1fe7d0572036fd3189ad93bafb71fc92ea9f36c134cc13</citedby><cites>FETCH-LOGICAL-c4894-317a974e98552e2c97a1fe7d0572036fd3189ad93bafb71fc92ea9f36c134cc13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjth.12914$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjth.12914$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,786,790,27957,27958,50923,51032</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25819920$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mearns, E. S.</creatorcontrib><creatorcontrib>Coleman, C. I.</creatorcontrib><creatorcontrib>Patel, D.</creatorcontrib><creatorcontrib>Saulsberry, W. J.</creatorcontrib><creatorcontrib>Corman, A.</creatorcontrib><creatorcontrib>Li, D.</creatorcontrib><creatorcontrib>Hernandez, A. V.</creatorcontrib><creatorcontrib>Kohn, C. G.</creatorcontrib><title>Index clinical manifestation of venous thromboembolism predicts early recurrence type and frequency: a meta‐analysis of randomized controlled trials</title><title>Journal of thrombosis and haemostasis</title><addtitle>J Thromb Haemost</addtitle><description>Summary
Background
Observational studies suggest index clinical manifestation of venous thromboembolism (VTE) predicts recurrence type. Data regarding the association between index manifestation and recurrence rates are conflicting.
Objectives
To perform a meta‐analysis of randomized controlled trials (RCTs) to determine the type and frequency of recurrent VTE (rVTE) in persons after an index deep vein thrombosis (DVT) or pulmonary embolism (PE).
Patients/Methods
We searched bibliographic databases for RCTs of acute (early) treatment of rVTE in persons with an index DVT or PE (±DVT), enrolling ≥ 50 subjects anticoagulated ≥ 3‐months and reporting types of rVTE. We pooled (random‐effects) the proportion of rVTEs that were DVTs, PEs, and fatal PEs, the proportion of recurrent PEs that were fatal, and absolute rVTE rates.
Results
In nine RCTs (N = 13 640; 413 rVTEs) evaluating persons with an index PE; 66% (95% CI, 60–72%) of rVTEs were PE and 27% (95% CI, 22–33%) were fatal PE. Among 25 RCTs (N = 17 340; 692 rVTEs) evaluating persons with an index DVT, 36% (95% CI, 29–44%) experienced a recurrent PE and 10% (95% CI, 7–13%) a fatal PE. Recurrent PEs following an index PE had a higher fatality rate than after an index DVT (41%; 95% CI, 33–48% vs. 25%; 95% CI, 18–33%; P = 0.007). The rVTE rate was higher following an index DVT compared with a PE (2.6%; 95% CI, 1.6–3.8% vs. 4.9%; 95% CI, 4.0–6.0%; P = 0.002).
Conclusions
Our meta‐analysis suggests most rVTEs will be the same type as the index event. While index DVTs are associated with a higher rVTE rate than index PEs; recurrent PEs are associated with high fatality.</description><subject>Anticoagulants - therapeutic use</subject><subject>Bibliographic data bases</subject><subject>Clinical trials</subject><subject>deep vein thrombosis</subject><subject>Humans</subject><subject>Medical treatment</subject><subject>meta‐analysis</subject><subject>Predictive Value of Tests</subject><subject>pulmonary embolism</subject><subject>Pulmonary Embolism - diagnosis</subject><subject>Pulmonary Embolism - drug therapy</subject><subject>Pulmonary Embolism - mortality</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Recurrence</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>venous thromboembolism</subject><subject>Venous Thromboembolism - diagnosis</subject><subject>Venous Thromboembolism - drug therapy</subject><subject>Venous Thromboembolism - mortality</subject><subject>venous thrombosis</subject><subject>Venous Thrombosis - diagnosis</subject><subject>Venous Thrombosis - drug therapy</subject><subject>Venous Thrombosis - mortality</subject><issn>1538-7933</issn><issn>1538-7836</issn><issn>1538-7836</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><recordid>eNp1kUtOBCEQhonROONj4QUMiSsXow30C3fG-MwkbnTdYegiMqFhBFptVx7BlQf0JKIzupMEqkK-fKnUj9AeyY5IOsfz-HBEKCf5GhqTgtWTqmbl-m_PGRuhrRDmWUZ4QbNNNKJFTTin2Rh9XNsWXrA02mopDO6E1QpCFFE7i53CT2BdH3B88K6bOUjX6NDhhYdWyxgwCG8G7EH23oOVgOOwACxsi5WHxz59DSdY4A6i-Hx7F1aYIejwbfYJcp1-hRZLZ6N3xqQ2ei1M2EEbKhXYXdVtdH9xfnd2NZneXl6fnU4nMq95PmGkErzKgddFQYFKXgmioGqzoqIZK1XLSM1Fy9lMqFlFlOQUBFeslITlMj3b6GDpXXiXhg2xmbvepyFDQ8o6zwtalnmiDpeU9C4ED6pZeN0JPzQka74TaFICzU8Cid1fGftZB-0f-bvyBBwvgWdtYPjf1NzcXS2VX_E-lMA</recordid><startdate>201506</startdate><enddate>201506</enddate><creator>Mearns, E. S.</creator><creator>Coleman, C. I.</creator><creator>Patel, D.</creator><creator>Saulsberry, W. J.</creator><creator>Corman, A.</creator><creator>Li, D.</creator><creator>Hernandez, A. V.</creator><creator>Kohn, C. G.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope></search><sort><creationdate>201506</creationdate><title>Index clinical manifestation of venous thromboembolism predicts early recurrence type and frequency: a meta‐analysis of randomized controlled trials</title><author>Mearns, E. S. ; Coleman, C. I. ; Patel, D. ; Saulsberry, W. J. ; Corman, A. ; Li, D. ; Hernandez, A. V. ; Kohn, C. G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4894-317a974e98552e2c97a1fe7d0572036fd3189ad93bafb71fc92ea9f36c134cc13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Anticoagulants - therapeutic use</topic><topic>Bibliographic data bases</topic><topic>Clinical trials</topic><topic>deep vein thrombosis</topic><topic>Humans</topic><topic>Medical treatment</topic><topic>meta‐analysis</topic><topic>Predictive Value of Tests</topic><topic>pulmonary embolism</topic><topic>Pulmonary Embolism - diagnosis</topic><topic>Pulmonary Embolism - drug therapy</topic><topic>Pulmonary Embolism - mortality</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Recurrence</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>venous thromboembolism</topic><topic>Venous Thromboembolism - diagnosis</topic><topic>Venous Thromboembolism - drug therapy</topic><topic>Venous Thromboembolism - mortality</topic><topic>venous thrombosis</topic><topic>Venous Thrombosis - diagnosis</topic><topic>Venous Thrombosis - drug therapy</topic><topic>Venous Thrombosis - mortality</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mearns, E. S.</creatorcontrib><creatorcontrib>Coleman, C. I.</creatorcontrib><creatorcontrib>Patel, D.</creatorcontrib><creatorcontrib>Saulsberry, W. J.</creatorcontrib><creatorcontrib>Corman, A.</creatorcontrib><creatorcontrib>Li, D.</creatorcontrib><creatorcontrib>Hernandez, A. V.</creatorcontrib><creatorcontrib>Kohn, C. G.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><jtitle>Journal of thrombosis and haemostasis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mearns, E. S.</au><au>Coleman, C. I.</au><au>Patel, D.</au><au>Saulsberry, W. J.</au><au>Corman, A.</au><au>Li, D.</au><au>Hernandez, A. V.</au><au>Kohn, C. G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Index clinical manifestation of venous thromboembolism predicts early recurrence type and frequency: a meta‐analysis of randomized controlled trials</atitle><jtitle>Journal of thrombosis and haemostasis</jtitle><addtitle>J Thromb Haemost</addtitle><date>2015-06</date><risdate>2015</risdate><volume>13</volume><issue>6</issue><spage>1043</spage><epage>1052</epage><pages>1043-1052</pages><issn>1538-7933</issn><issn>1538-7836</issn><eissn>1538-7836</eissn><abstract>Summary
Background
Observational studies suggest index clinical manifestation of venous thromboembolism (VTE) predicts recurrence type. Data regarding the association between index manifestation and recurrence rates are conflicting.
Objectives
To perform a meta‐analysis of randomized controlled trials (RCTs) to determine the type and frequency of recurrent VTE (rVTE) in persons after an index deep vein thrombosis (DVT) or pulmonary embolism (PE).
Patients/Methods
We searched bibliographic databases for RCTs of acute (early) treatment of rVTE in persons with an index DVT or PE (±DVT), enrolling ≥ 50 subjects anticoagulated ≥ 3‐months and reporting types of rVTE. We pooled (random‐effects) the proportion of rVTEs that were DVTs, PEs, and fatal PEs, the proportion of recurrent PEs that were fatal, and absolute rVTE rates.
Results
In nine RCTs (N = 13 640; 413 rVTEs) evaluating persons with an index PE; 66% (95% CI, 60–72%) of rVTEs were PE and 27% (95% CI, 22–33%) were fatal PE. Among 25 RCTs (N = 17 340; 692 rVTEs) evaluating persons with an index DVT, 36% (95% CI, 29–44%) experienced a recurrent PE and 10% (95% CI, 7–13%) a fatal PE. Recurrent PEs following an index PE had a higher fatality rate than after an index DVT (41%; 95% CI, 33–48% vs. 25%; 95% CI, 18–33%; P = 0.007). The rVTE rate was higher following an index DVT compared with a PE (2.6%; 95% CI, 1.6–3.8% vs. 4.9%; 95% CI, 4.0–6.0%; P = 0.002).
Conclusions
Our meta‐analysis suggests most rVTEs will be the same type as the index event. While index DVTs are associated with a higher rVTE rate than index PEs; recurrent PEs are associated with high fatality.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>25819920</pmid><doi>10.1111/jth.12914</doi><tpages>10</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1538-7933 |
| ispartof | Journal of thrombosis and haemostasis, 2015-06, Vol.13 (6), p.1043-1052 |
| issn | 1538-7933 1538-7836 1538-7836 |
| language | eng |
| recordid | cdi_proquest_journals_1684452664 |
| source | Wiley; Free E-Journal (出版社公開部分のみ） |
| subjects | Anticoagulants - therapeutic use Bibliographic data bases Clinical trials deep vein thrombosis Humans Medical treatment meta‐analysis Predictive Value of Tests pulmonary embolism Pulmonary Embolism - diagnosis Pulmonary Embolism - drug therapy Pulmonary Embolism - mortality Randomized Controlled Trials as Topic Recurrence Risk Assessment Risk Factors Time Factors Treatment Outcome venous thromboembolism Venous Thromboembolism - diagnosis Venous Thromboembolism - drug therapy Venous Thromboembolism - mortality venous thrombosis Venous Thrombosis - diagnosis Venous Thrombosis - drug therapy Venous Thrombosis - mortality |
| title | Index clinical manifestation of venous thromboembolism predicts early recurrence type and frequency: a meta‐analysis of randomized controlled trials |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-09-22T02%3A22%3A54IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Index%20clinical%20manifestation%20of%20venous%20thromboembolism%20predicts%20early%20recurrence%20type%20and%20frequency:%20a%20meta%E2%80%90analysis%20of%20randomized%20controlled%20trials&rft.jtitle=Journal%20of%20thrombosis%20and%20haemostasis&rft.au=Mearns,%20E.%20S.&rft.date=2015-06&rft.volume=13&rft.issue=6&rft.spage=1043&rft.epage=1052&rft.pages=1043-1052&rft.issn=1538-7933&rft.eissn=1538-7836&rft_id=info:doi/10.1111/jth.12914&rft_dat=%3Cproquest_cross%3E3700990091%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c4894-317a974e98552e2c97a1fe7d0572036fd3189ad93bafb71fc92ea9f36c134cc13%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=1684452664&rft_id=info:pmid/25819920&rfr_iscdi=true |