Μακροχρόνια παρακολούθηση ασθενών με πνευμονική εμβολή
|
|
- Roy Shields
- 6 years ago
- Views:
Transcription
1 Μακροχρόνια παρακολούθηση ασθενών με πνευμονική εμβολή Ευφροσύνη Δ. Μάναλη Λέκτορας Β Πανεπιστημιακή Πνευμονολογική Κλινική ΓΝΑ «Αττικόν» Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών
2 Existing guidelines recommend therapeutic anticoagulation for all patients with acute pulmonary embolism (PE) for at least three months. PL den Exter, et al. Blood Reviews 2013; 27:
3
4
5 Konstantinides S, et al. Eur Heart J 2012; 33(24):
6 These guidelines however do not provide a clear recommendation on the frequency and duration of medical follow-up. Generally, this latter ends at the moment of anticoagulant cessation, despite current insight that the long-term clinical course of acute PE is frequently complicated by several thrombotic and non-thrombotic adverse events
7 It has even been shown that half of the patients with acute PE suffer from at least one major complication within four years after initial diagnosis Klok FA, et al. Am J Respir Crit Care Med 2010; 181:
8
9
10 This represents a relative increase in risk of death of 12.6-fold for our study cohort s youngest quintile compared with the general population. For the oldest quintile, the relative risk increase was 1.9-fold.
11
12
13
14 It is important to note that the increased mortality in this population could not be solely assigned to baseline comorbidity. In 351 patients with a Charlson Comorbidity Index score of 0 at baseline (ie, no comorbidities), there were 44 (13%) deaths post-discharge, of which 19 (43%) were cardiovascular (3 due to recurrent PE, 6 to myocardial infarction, 4 to heart failure, 2 to cardiac-related causes, and 4 to stroke) and 4 (9%) were due to malignancy.
15 However, further research in this field and controlled clinical trials are warranted before recommendations can be established which risk factors should be therapeutically targeted to prevent ATE in the years following a PE diagnosis. Whereas there are well-developed guidelines for the long-term follow-up of patients with coronary disease and heart failure, current guidelines do not recommend the long-term follow-up of patients post-pe. The current study shows that this is unsupportable for any age group, including those in the youngest quintile and those without baseline comorbidities.
16 Recurrent venous thromboembolism Venous thrombosis is a common disease with a yearly incidence of around one case per 1000 person-years. In a third of patients deep venous thrombosis is complicated by embolization of the clot into the lungs Venous thrombosis is a chronic disease that often recurs. In unselected cohorts of patients with venous thrombosis, the risk of recurrence after 5 years is 20 25%, and is higher than 25% in patients with unprovoked venous thrombosis Lancet 2010; 376: Recurrent PE is associated with a considerable case-fatality rate of 5.0% 14%
17
18
19
20 Kearon C, et al. Circulation 2004; 110: I10-I18
21
22
23 Abnormalities that are associated with an increased risk of venous thrombosis, and that are detectable with laboratory techniques, can be established in more than 50% of patients with a first unprovoked venous thrombosis. Recurrent venous thrombosis can only be prevented by indefinite anticoagulation treatment, which confers a substantial risk of haemorrhage.
24
25 Lip GYH, et al. Europace 2011; 13:
26
27
28
29
30 A third of patients with recurrent unprovoked venous thrombosis have a normal test result. A negative finding from thrombophilia testing could therefore result in a false sense of safety for patients. Lancet 2010; 376:
31 The rate of symptomatic VTE in patients with cancer who have been hospitalized approaches 5%. VTE, especially when unprovoked, may herald an impending diagnosis of cancer in a subset of patients without known malignancy.
32 In patients with venous thromboembolism (VTE), 15 20% will have prevalent cancer when VTE is diagnosed In patients with a first VTE and without prevalent cancer, the risk for new cancer is about 1 2% per year, appears to be uniform over time, and is higher in patients with unprovoked VTE and those with advanced age.
33
34 The risk of recurrent VTE is 3-fold higher in patients with cancer who experience an initial venous thromboembolic event in comparison with patients who do not have cancer and develop VTE Mortality after hospital discharge is nearly double among patients with cancer who subsequently developed VTE in comparison with those who do not
35 Because patients who have cancer with VTE have an increased risk of recurrent VTE, the 2012 American College of Chest Physicians Evidence- Based Clinical Practice Guidelines on Antithrombotic Therapy for VTE Disease recommend extended-duration anticoagulant therapy over time-limited anticoagulation in patients with active cancer, especially if the risk of bleeding is not elevated. Because patients with cancer who are receiving anticoagulation for VTE treatment have at least a 2-fold increased risk of major bleeding in comparison with patients without cancer who are receiving anticoagulant therapy for VTE, patients with cancer who are receiving extended-duration anticoagulation for secondary prevention should be monitored closely for bleeding
36
37 Chronic thromboembolic pulmonary hypertension Incomplete thromboembolic resolution after PE may result in the development of CTEPH, which is characterized by intraluminal thrombus organization to endothelialized residua resulting in fibrous stenosis or complete obliteration of the pulmonary arteries Also, for reasons still unidentified, 25 40% of patients with established CTEPH lack a prior history of symptomatic PE or DVT
38 Bonderman D, et al. Eur Respir J 2009; 33:
39 N Engl J Med 2004;350:
40
41 Acta Radiol : 728
42 CHEST 2009; 136:
43 For example, from the time of diagnosis to the 6-month follow-up, the percentage of patients treated with standard anticoagulation with manifest RV hypokinesis decreased from 20% to 7%, and this same end point among patients treated with heparin and alteplase decreased from 57% to 6%. Symptom-based, selective monitoring may be an insensitive screening measure for the identification of patients with tricuspid regurgitation suggestive of high right-side heart pressures. Only 9 of 39 patients who manifested an increase in RVSP admitted to dyspnea at rest (NYHA score, 4) at the 6-month follow-up, but 10 more patients admitted to shortness of breath every day with walking.
44 Survival without intervention is poor In one study, the 5-year survival rate in patients with CTEPH was 30% when the mean pulmonary artery pressure was >40 mm Hg and 10% when it was >50 mm Hg
45 Further recommendations for post thrombotic syndrome
46 Further recommendations for drug interactions
47 Further recommendations for hematological monitoring
48 importance of patient information and education relating to lifestyle issues while on anticoagulation, when receiving dental treatment and during pregnancy
49 CHEST 2012; 141(2)(Suppl):e691S e736s
50
51 The term clinical vigilance refers to patient and physician alertness to the signs and symptoms of VTE and awareness of the need for timely and appropriate objective investigation of women with symptoms suspicious of DVT or PE. A family history of VTE refers to DVT or PE in a first-degree relative
52
53 Long term follow-up for patients with pulmonary embolism Recommendations Optimization of treatment Optimization of duration of treatment Evaluation for major bleeding complications Laboratory monitoring and screening Regular follow-up for cardiovascular disease Regular follow-up for chronic thromboembolic pulmonary hypertension Screening for cancer Special recommendation for VTE complicating pregnancy Everyday lifestyle issues Good patient-health care provider communication Increased clinical vigilance
54 Σας ευχαριστώ πολύ
VENOUS THROMBOEMBOLISM: DURATION OF TREATMENT
VENOUS THROMBOEMBOLISM: DURATION OF TREATMENT OBJECTIVE: To provide guidance on the recommended duration of anticoagulant therapy for venous thromboembolism (VTE). BACKGROUND: Recurrent episodes of VTE
More informationChapter 1. Introduction
Chapter 1 Introduction Introduction 9 Even though the first reports on venous thromboembolism date back to the 13 th century and the mechanism of acute pulmonary embolism (PE) was unraveled almost 150
More informationReal life management of CTEPH: patient case
2 nd International Congress on cardiovascular imaging in clinical practice k Real life management of CTEPH: patient case Anastasia Anthi Pulmonary Hypertension Clinic, Attikon University Hospital, Athens
More informationScreening for CETPH after acute pulmonary embolism: is it needed? Menno V. Huisman Department of Vascular Medicine LUMC Leiden
Screening for CETPH after acute pulmonary embolism: is it needed? Menno V. Huisman Department of Vascular Medicine LUMC Leiden m.v.huisman@lumc.nl Background CETPH Chronic Thrombo Embolic Pulmonary Hypertension
More informationCover Page. The handle holds various files of this Leiden University dissertation
Cover Page The handle http://hdl.handle.net/1887/40114 holds various files of this Leiden University dissertation Author: Exter, Paul L. den Title: Diagnosis, management and prognosis of symptomatic and
More informationDuration of Anticoagulant Therapy. Linda R. Kelly PharmD, PhC, CACP September 17, 2016
Duration of Anticoagulant Therapy Linda R. Kelly PharmD, PhC, CACP September 17, 2016 Conflicts of Interest No conflicts of interest to report Objectives At the end of the program participants will be
More informationVTE in Children: Practical Issues
VTE in Children: Practical Issues Wasil Jastaniah MBBS,FAAP,FRCPC Consultant Pediatric Hem/Onc/BMT May 2012 Top 10 Reasons Why Pediatric VTE is Different 1. Social, ethical, and legal implications. 2.
More informationDuration of Anticoagulation? Peter Verhamme MD, PhD Department of Cardiovascular Medicine University of Leuven Belgium
Duration of Anticoagulation? Peter Verhamme MD, PhD Department of Cardiovascular Medicine University of Leuven Belgium Disclosures Honoraria and research support: Daiichi-Sankyo, Boehringer Ingelheim,
More informationAre there still any valid indications for thrombophilia screening in DVT?
Carotid artery stenosis and risk of stroke Are there still any valid indications for thrombophilia screening in DVT? Armando Mansilha MD, PhD, FEBVS Faculty of Medicine of University of Porto Munich, 2016
More informationUnderstanding thrombosis in venous thromboembolism. João Morais Head of Cardiology Division and Research Centre Leiria Hospital Centre Portugal
Understanding thrombosis in venous thromboembolism João Morais Head of Cardiology Division and Research Centre Leiria Hospital Centre Portugal Disclosures João Morais On the last year JM received honoraria
More informationRyan Walsh, MD Department of Emergency Medicine Madigan Army Medical Center
Ryan Walsh, MD Department of Emergency Medicine Madigan Army Medical Center The opinions expressed herein are solely those of the author and do not represent the official views of the Department of Defense
More informationCover Page. The handle holds various files of this Leiden University dissertation.
Cover Page The handle http://hdl.handle.net/1887/21764 holds various files of this Leiden University dissertation. Author: Mos, Inge Christina Maria Title: A more granular view on pulmonary embolism Issue
More informationA VENOUS THROMBOEMBOLISM (VTE) TOWN HALL: Answering Your Top Questions on Treatment and Secondary Prevention
A VENOUS THROMBOEMBOLISM (VTE) TOWN HALL: Answering Your Top Questions on Treatment and Secondary Prevention This handout is a supplemental resource to an educational video activity released on Medscape
More informationClinical Policy: Dalteparin (Fragmin) Reference Number: ERX.SPA.207 Effective Date:
Clinical Policy: (Fragmin) Reference Number: ERX.SPA.207 Effective Date: 01.11.17 Last Review Date: 11.17 Revision Log See Important Reminder at the end of this policy for important regulatory and legal
More informationUpdates in Medical Management of Pulmonary Embolism and Deep Vein Thrombosis. By: Justin Youtsey, Elliott Reiff, William Montgomery, Grant Finlan
Updates in Medical Management of Pulmonary Embolism and Deep Vein Thrombosis By: Justin Youtsey, Elliott Reiff, William Montgomery, Grant Finlan Objectives Describe the prevalence of PE and DVT as it relates
More informationA Review of the Role of Non-Vitamin K Oral Anticoagulants in the Acute and Long-Term Treatment of Venous Thromboembolism
Cardiol Ther (2018) 7:1 13 https://doi.org/10.1007/s40119-018-0107-0 REVIEW A Review of the Role of Non-Vitamin K Oral Anticoagulants in the Acute and Long-Term Treatment of Venous Thromboembolism Andrew
More informationHow long to continue anticoagulation after DVT?
How long to continue anticoagulation after DVT? Dr. Nihar Ranjan Pradhan M.S., DNB (Vascular Surgery), FVES(UK) Consultant Vascular Surgeon Apollo Hospital, Jubilee Hills, Hyderabad (Formerly Faculty in
More informationThrombophilia. Diagnosis and Management. Kevin P. Hubbard, DO, FACOI
Thrombophilia Diagnosis and Management Kevin P. Hubbard, DO, FACOI Clinical Professor of Medicine Kansas City University of Medicine and Biosciences-College of Osteopathic Medicine Kansas City, Missouri
More informationThe Evidence Base for Treating Acute DVT
The Evidence Base for Treating Acute DVT Mr Chung Sim Lim Consultant Vascular Surgeon and Honorary Lecturer Royal Free London NHS Foundation Trust and University College London NIHR UCLH Biomedical Research
More informationUPDATE ON TREATMENT OF ACUTE VENOUS THROMBOSIS
UPDATE ON TREATMENT OF ACUTE VENOUS THROMBOSIS Armando Mansilha MD, PhD, FEBVS 16 th National Congress of the Italian Society of Vascular and Endovascular Surgery Bologna, 2017 Disclosure I have the following
More informationChapter 8. F.A. Klok, K.W. van Kralingen, A.P.J. van Dijk, F.H. Heyning, H.W. Vliegen and M.V. Huisman. Haematologica 2009; in press
Chapter 8 Prospective cardiopulmonary screening program to detect chronic thromboembolic pulmonary hypertension in patients after acute pulmonary embolism F.A. Klok, K.W. van Kralingen, A.P.J. van Dijk,
More informationRecurrence risk after anticoagulant treatment of limited duration for late, second venous thromboembolism
ARTICLES Coagulation & its Disorders Recurrence risk after anticoagulant treatment of limited duration for late, second venous thromboembolism Tom van der Hulle, Melanie Tan, Paul L. den Exter, Mark J.G.
More informationEpidemiologia e clinica del tromboembolismo venoso. Maria Ciccone Sezione di Ematologia e Fisiopatologia della Coagulazione
Epidemiologia e clinica del tromboembolismo venoso Maria Ciccone Sezione di Ematologia e Fisiopatologia della Coagulazione Thrombophilia may present clinically as one or more of several thrombotic manifestations
More informationPULMONARY EMBOLISM (PE): DIAGNOSIS AND TREATMENT
PULMONARY EMBOLISM (PE): DIAGNOSIS AND TREATMENT OBJECTIVE: To provide a diagnostic algorithm and treatment options for patients with acute pulmonary embolism (PE). BACKGROUND: Venous thromboembolism (VTE)
More informationMassive and Submassive Pulmonary Embolism: 2017 Update and Future Directions
Massive and Submassive Pulmonary Embolism: 2017 Update and Future Directions Kush R Desai, MD Assistant Professor of Radiology Northwestern University Feinberg School of Medicine Chicago, IL Disclosures
More informationComparison of Venothromboembolism Prophylaxis Practices in a Winnipeg Tertiary Care Hospital to Chest Guidelines: A Quality Improvement Project
Comparison of Venothromboembolism Prophylaxis Practices in a Winnipeg Tertiary Care Hospital to Chest Guidelines: A Quality Improvement Project Dr. Jonathan Laxton, FRCPC, R5 GIM University of Manitoba
More informationRISK STRATIFICATION OF PATIENTS WITH ACUTE SYMPTOMATIC PULMONARY EMBOLISM. David Jiménez, MD, PhD, FCCP Ramón y Cajal Hospital, IRYCIS Madrid, Spain
RISK STRATIFICATION OF PATIENTS WITH ACUTE SYMPTOMATIC PULMONARY EMBOLISM David Jiménez, MD, PhD, FCCP Ramón y Cajal Hospital, IRYCIS Madrid, Spain Potential Conflicts of Interest Financial conflicts of
More informationDisclosures. DVT: Diagnosis and Treatment. Questions To Ask. Dr. Susanna Shin - DVT: Diagnosis and Treatment. Acute Venous Thromboembolism (VTE) None
Disclosures DVT: Diagnosis and Treatment None Susanna Shin, MD, FACS Assistant Professor University of Washington Acute Venous Thromboembolism (VTE) Deep Venous Thrombosis (DVT) Pulmonary Embolism (PE)
More informationPerioperative Management of the Anticoagulated Patient
Perioperative Management of the Anticoagulated Patient Citywide Resident Perioperative Medical Consultation Conference 5/5/17 Matthew Eisen, MD Director, Anticoagulation Services MetroHealth Medical Center
More informationMabel Labrada, MD Miami VA Medical Center
Mabel Labrada, MD Miami VA Medical Center *1-Treatment for acute DVT with underlying malignancy is for 3 months. *2-Treatment of provoked acute proximal DVT can be stopped after 3months of treatment and
More informationDiagnosis and Treatment of Deep Venous Thrombosis and Pulmonary Embolism
Agency for Healthcare Research and Quality Evidence Report/Technology Assessment Diagnosis and Treatment of Deep Venous Thrombosis and Pulmonary Embolism Summary Number 68 Overview Venous thromboembolism
More informationDVT - initial management NSCCG
Background information Information resources for patients and carers Updates to this care map Synonyms Below knee DVT and bleeding risks Patient with confirmed DVT Scan confirms superficial thrombophlebitis
More informationDVT PROPHYLAXIS IN HOSPITALIZED MEDICAL PATIENTS SAURABH MAJI SR (PULMONARY,MEDICINE)
DVT PROPHYLAXIS IN HOSPITALIZED MEDICAL PATIENTS SAURABH MAJI SR (PULMONARY,MEDICINE) Introduction VTE (DVT/PE) is an important complication in hospitalized patients Hospitalization for acute medical illness
More informationCanadian Society of Internal Medicine Annual Meeting 2016 Montreal, QC
Canadian Society of Internal Medicine Annual Meeting 2016 Montreal, QC 1 st workshop: update to VTE guidelines in 2016 2 nd workshop: VTE controversies + new horizons André Roussin MD, FRCP, CSPQ CHUM
More informationAmerican College of Cardiology 66th Annual Scientific Session (ACC.17):
News Release Not intended for U.S. and UK Media Bayer AG Communications and Public Affairs 51368 Leverkusen Germany Tel. +49 214 30-0 www.news.bayer.com American College of Cardiology 66th Annual Scientific
More informationVenous Thrombo-Embolism (VTE)
Venous Thrombo-Embolism (VTE) Information for service users and carers RDaSH leading the way with care Older People s Mental Health Services Reducing risk of unwanted blood clots whilst in hospital About
More informationAntiplatelet and Anti-Thrombotic Therapy. Ivan Anderson, MD RIHVH Cardiology
Antiplatelet and Anti-Thrombotic Therapy Ivan Anderson, MD RIHVH Cardiology Outline Anti-thrombotic therapy Risk stratification of stroke with atrial fibrillation DVT and PE treatment Pharmacology Anti-platelet
More informationIs it safe to manage pulmonary embolism in Primary Care? Roopen Arya King s College Hospital
Is it safe to manage pulmonary embolism in Primary Care? Roopen Arya King s College Hospital A few definitions Safe Avoid death, recurrent thrombosis, bleeding Manage Diagnosis + treatment Pulmonary embolism
More informationPrevention of VTE Sequelae: Post-thrombotic Syndrome and Chronic Thromboembolic Pulmonary Hypertension
Prevention of VTE Sequelae: Post-thrombotic Syndrome and Chronic Thromboembolic Pulmonary Hypertension Susan R. Kahn MD MSc Professor of Medicine, McGill University Director, Jewish General Hospital Centre
More informationClinical Policy: Dalteparin (Fragmin) Reference Number: CP.PHAR.225
Clinical Policy: (Fragmin) Reference Number: CP.PHAR.225 Effective Date: 05/16 Last Review Date: 05/17 Coding Implications Revision Log See Important Reminder at the end of this policy for important regulatory
More informationPROGNOSIS AND SURVIVAL
CANCER ASSOCIATED THROMBOSIS PROGNOSIS AND SURVIVAL Since French internist Armand Trousseau reported the occurrence of mysterious thrombotic disorders in cancer patients in the mid-19th century, the link
More informationManagement of Acute Pulmonary Embolism. Judith Hurdman Consultant Respiratory Physician
Management of Acute Pulmonary Embolism Judith Hurdman Consultant Respiratory Physician Judith.hurdman@sth.nhs.uk Overview Risk Stratification Who can be managed as an outpatient? To thrombolyse or not
More informationEXTENDING VTE PROPHYLAXIS IN ACUTELY ILL MEDICAL PATIENTS
EXTENDING VTE PROPHYLAXIS IN ACUTELY ILL MEDICAL PATIENTS Samuel Z. Goldhaber, MD Director, VTE Research Group Cardiovascular Division Brigham and Women s Hospital Professor of Medicine Harvard Medical
More informationHow to prevent thrombotic diseases? Sergio Fusco, MD
How to prevent thrombotic diseases? Sergio Fusco, MD Geriatric Division - Department of Internal Medicine Ospedale Dell'Angelo - Venice, Italy CONFLICT OF INTEREST DISCLOSURE I have no potential conflict
More informationCURRENT & FUTURE THERAPEUTIC MANAGEMENT OF VENOUS THROMBOEMBOLISM. Gordon Lowe Professor of Vascular Medicine University of Glasgow
CURRENT & FUTURE THERAPEUTIC MANAGEMENT OF VENOUS THROMBOEMBOLISM Gordon Lowe Professor of Vascular Medicine University of Glasgow VENOUS THROMBOEMBOLISM Common cause of death and disability 50% hospital-acquired
More informationFocus: l embolia polmonare Per quanto la terapia anticoagulante orale? Giulia Magnani 27 Gennaio, 2018
Focus: l embolia polmonare Per quanto la terapia anticoagulante orale? Giulia Magnani 27 Gennaio, 2018 NO DISCLOSURE Pulmonary Embolism Venous thromboembolism (VT) is the third most common cause of cardiovascular
More informationCover Page. The handle holds various files of this Leiden University dissertation
Cover Page The handle http://hdl.handle.net/1887/40114 holds various files of this Leiden University dissertation Author: Exter, Paul L. den Title: Diagnosis, management and prognosis of symptomatic and
More informationVENOUS THROMBOEMBOLISM AND CORONARY ARTERY DISEASE: IS THERE A LINK?
VENOUS THROMBOEMBOLISM AND CORONARY ARTERY DISEASE: IS THERE A LINK? Ayman El-Menyar (1), MD, Hassan Al-Thani (2),MD (1)Clinical Research Consultant, (2) Head of Vascular Surgery, Hamad General Hospital
More informationChanging the Ambulatory Training Paradigm: The Design and Implementation of an Outpatient Pulmonology Fellowship Curriculum
Online Data Supplement Changing the Ambulatory Training Paradigm: The Design and Implementation of an Outpatient Pulmonology Fellowship Curriculum Stacey M. Kassutto, C. Jessica Dine, Maryl Kreider, Rupal
More informationTechnology appraisal guidance Published: 17 December 2014 nice.org.uk/guidance/ta327
Dabigatran an etexilate for the treatment and secondary prevention ention of deep vein thrombosis and/or pulmonary embolism Technology appraisal guidance Published: 17 December 2014 nice.org.uk/guidance/ta327
More informationClinical Policy: Dalteparin (Fragmin) Reference Number: ERX.SPA.207 Effective Date:
Clinical Policy: (Fragmin) Reference Number: ERX.SPA.207 Effective Date: 01.11.17 Last Review Date: 02.18 Revision Log See Important Reminder at the end of this policy for important regulatory and legal
More informationLandmark Phase III Study of Bayer s Xarelto (Rivaroxaban) Initiated for the Secondary Prevention of Myo
Xarelto (Rivaroxaban) Landmark Phase III Study of Bayer s Xarelto (Rivaroxaban) Initiated for the Secondary Prevention of Myocardial Infarction and Death in Patients with Coronary or Peripheral Artery
More informationEpidemiology. Update on Pulmonary Embolism. Keys to PE Management 5/5/2014. Diagnosis. Risk stratification. Treatment
Update on Pulmonary Embolism Steven M. Dean, DO, FACP, RPVI Program Director- Vascular Medicine Associate Professor of Internal Medicine Division of Cardiovascular Medicine The Ohio State University Keys
More informationPREVENTION AND TREATMENT OF VENOUS THROMBOEMBOLISM
PREVENTION AND TREATMENT OF VENOUS THROMBOEMBOLISM International Consensus Statement 2013 Guidelines According to Scientific Evidence Developed under the auspices of the: Cardiovascular Disease Educational
More informationTitle: Low Molecular Weight Heparins (LMWH), fondaparinux (Arixtra)
Origination: 03/29/05 Revised: 09/01/10 Annual Review: 11/20/13 Purpose: To provide guidelines and criteria for the review and decision determination of requests for medications that requires prior authorization.
More informationHandbook for Venous Thromboembolism
Handbook for Venous Thromboembolism Gregory Piazza Benjamin Hohlfelder Samuel Z. Goldhaber Handbook for Venous Thromboembolism Gregory Piazza Cardiovascular Division Harvard Medical School Brigham and
More informationBayer s Rivaroxaban Demonstrated Superior Protection Against Recurrent Venous Thromboembolism Compared with Aspirin in EINSTEIN CHOICE Study
News Release Not intended for U.S. and UK Media Bayer AG Communications and Public Affairs 51368 Leverkusen Germany Tel. +49 214 30-0 www.news.bayer.com New Late-Breaking Study Data Presented at ACC.17:
More informationDave Duddleston, MD VP and Medical Director Southern Farm Bureau Life
Dave Duddleston, MD VP and Medical Director Southern Farm Bureau Life Sources of Risk for Venous Diseases Pulmonary embolism (thrombus) Bleeding from anticoagulation Mortality from underlying disease Chronic
More informationVenous thromboembolic diseases: diagnosis, management and thrombophilia testing (2012) NICE guideline CG144
Venous thromboembolic diseases: diagnosis, management and thrombophilia testing (2012) NICE guideline CG144 Appendix A: Summary of new evidence from Summary of evidence from previous year Diagnosis Diagnostic
More informationWGA meeting Management and follow-up VTE in clinical pratice Dr Borgoens CHR Citadelle Liège
WGA meeting 2016 Management and follow-up VTE in clinical pratice Dr Borgoens CHR Citadelle Liège Clinical question Which complementary investigations are you going to plan during or early after hospitalization
More informationA 50-year-old woman with syncope
Hira Shahzad 1, Ali Bin Sarwar Zubairi 2 1 Medical College, Aga Khan University Hospital, Karachi 2 Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan Ali Bin Sarwar Zubairi Associate
More informationLow Molecular Weight Heparin for Prevention and Treatment of Venous Thromboembolic Disorders
SURGICAL GRAND ROUNDS March 17 th, 2007 Low Molecular Weight Heparin for Prevention and Treatment of Venous Thromboembolic Disorders Guillermo Escobar, M.D. LMWH vs UFH Jayer s sales pitch: FALSE LMW is
More informationDr. Rami M. Adil Al-Hayali Assistant Professor in Medicine
Dr. Rami M. Adil Al-Hayali Assistant Professor in Medicine Venous thromboembolism: pulmonary embolism (PE) deep vein thrombosis (DVT) 1% of all patients admitted to hospital 5% of in-hospital mortality
More informationDuration of anticoagulation
Duration of anticoagulation P. Fontana Service d angiologie et d hémostase Hôpitaux Universitaires de Genève Pomeriggio formativo in coagulazione, Bellinzona, 19.10.2017 Conflict of interest AstraZeneca,
More informationDrug Class Review Newer Oral Anticoagulant Drugs
Drug Class Review Newer Oral Anticoagulant Drugs Final Original Report May 2016 The purpose of reports is to make available information regarding the comparative clinical effectiveness and harms of different
More informationEpidermiology Early pulmonary embolism
Epidermiology Early pulmonary embolism Sitang Nirattisaikul Faculty of Medicine, Prince of Songkla University 3 rd most common cause of cardiovascular death in the United States, following ischemic heart
More informationVenous Thromboembolism Prophylaxis - Why Should We Care? Harry Gibbs FRACP FCSANZ Vascular Physician The Alfred Hospital
Venous Thromboembolism Prophylaxis - Why Should We Care? Harry Gibbs FRACP FCSANZ Vascular Physician The Alfred Hospital VTE is common and dangerous 5 VTE is Common VTE Incidence: 1.5 / 1000 per year
More informationEarly Ambulation Reduces the Risk of Venous Thromboembolism After Total Knee Replacement. Marilyn Szekendi, PhD, RN
Early Ambulation Reduces the Risk of Venous Thromboembolism After Total Knee Replacement Marilyn Szekendi, PhD, RN ANA 7 th Annual Nursing Quality Conference, February 2013 Research Team Banafsheh Sadeghi,
More informationInsights from whole genome sequencing of a family with Venous Thromboembolism
Insights from whole genome sequencing of a family with Venous Thromboembolism Mariza de Andrade, PhD Professor of Biostatistics Division of Biomedical Statistics and Informatics Mayo Clinic, Rochester,
More informationClinical Policy Title: Genetic testing for G1691A polymorphism factor V Leiden
Clinical Policy Title: Genetic testing for G1691A polymorphism factor V Leiden Clinical Policy Number: 05.01.03 Effective Date: January 1, 2016 Initial Review Date: July 15, 2015 Most Recent Review Date:
More informationDuration anticoagulation VTE. Clinical case WGA april 2017 Dr Borgoens
Duration anticoagulation VTE Clinical case WGA april 2017 Dr Borgoens Clinical case 70 y old, sedentary computer engineer 1 st episode intermediate high risk pulmonaryembolism(rv dysfunction, positives
More informationDEEP VEIN THROMBOSIS (DVT): TREATMENT
DEEP VEIN THROMBOSIS (DVT): TREATMENT OBJECTIVE: To provide an evidence-based approach to treatment of patients presenting with deep vein thrombosis (DVT). BACKGROUND: An estimated 45,000 patients in Canada
More informationNEW/NOVEL ORAL ANTICOAGULANTS (NOACS): COMPARISON AND FREQUENTLY ASKED QUESTIONS
NEW/NOVEL ORAL ANTICOAGULANTS (NOACS): COMPARISON AND FREQUENTLY ASKED QUESTIONS OBJECTIVES: To provide a comparison of the new/novel oral anticoagulants (NOACs) currently available in Canada. To address
More information4/30/2018 CLOT+ In patients with an acute proximal deep vein thrombosis, pharmacomechanical catheter-directed thrombolysis does not reduce t
In patients with an acute proximal deep vein thrombosis, pharmacomechanical catheter-directed thrombolysis does not reduce the rate of post-thrombotic syndrome Question In patients who have symptomatic
More informationApproach to Thrombosis
Approach to Thrombosis Theera Ruchutrakool, M.D. Division of Hematology Department of Medicine Siriraj Hospital Faculty of Medicine Mahidol University Approach to Thrombosis Thrombosis: thrombus formation
More informationPE service. 65 years old lady. What would you do next? Risk stratification. What would you do next? Regional College Lecture PE Management
PE service Regional College Lecture PE Management Update in medicine (Eastern) Cambridge 29 th June 2017 Dr Rachel M Limbrey DM FRCP University Hospital Southampton NHS Foundation Trust Ambulatory acute
More informationResults from RE-COVER RE-COVER II RE-MEDY RE-SONATE EXECUTIVE SUMMARY
Assessment of the safety and efficacy of dabigatran etexilate (Pradaxa ) in the treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE) and the prevention of recurrent DVT and PE Results from
More informationHEPARIN-INDUCED THROMBOCYTOPENIA (HIT)
HEPARIN-INDUCED THROMBOCYTOPENIA (HIT) OBJECTIVE: To assist clinicians with the investigation and management of suspected and documented heparin-induced thrombocytopenia (HIT). BACKGROUND: HIT is a transient,
More informationBayer Pharma AG Berlin Germany Tel News Release. Not intended for U.S. and UK Media
News Release Not intended for U.S. and UK Media Bayer Pharma AG 13342 Berlin Germany Tel. +49 30 468-1111 www.bayerpharma.com Landmark Phase III Study of Bayer s Xarelto (Rivaroxaban) Initiated for the
More informationProstate Biopsy Alerts
Prostate Biopsy Alerts Saskatchewan Prostate Assessment Pathway Guidelines for the Primary Care Provider for Patient Preparation and the Management of Medications and Complications September 2016 Table
More informationBath, Philip M.W. and England, Timothy J. (2009) Thighlength compression stockings and DVT after stroke. Lancet. ISSN (In Press)
Bath, Philip M.W. and England, Timothy J. (2009) Thighlength compression stockings and DVT after stroke. Lancet. ISSN 0140-6736 (In Press) Access from the University of Nottingham repository: http://eprints.nottingham.ac.uk/1087/1/lancet_clots_1_20090522_4.pdf
More informationUse of EKOS Catheter in the management of Venous Mr. Manoj Niverthi, Mr. Sarang Pujari, and Ms. Nupur Dandavate, The GTF Group
Use of EKOS Catheter in the management of Venous Thromboembolism @ Mr. Manoj Niverthi, Mr. Sarang Pujari, and Ms. Nupur Dandavate, The GTF Group Introduction Georgia Thrombosis Forum (GTF, www.gtfonline.net)
More informationReducing the risk of venous thrombo-embolism (VTE) in hospital and after discharge
Reducing the risk of venous thrombo-embolism (VTE) in hospital and after discharge What is a venous thromboembolism (VTE)? This is a medical term that describes a blood clot that develops in a deep vein
More information1. SCOPE of GUIDELINE:
Page 1 of 35 CLINICAL PRACTICE GUIDELINE: Venous Thromboembolism (VTE) Prevention Guideline: Thromboprophylaxis AUTHORIZATION: VP, Medicine Date Approved: May 17, 2012 Date Revised: Vancouver Coastal Health
More informationUnderstanding Best Practices in Anticoagulation Therapy in Patients with Venous Thromboembolism. Rajat Deo, MD, MTR
Understanding Best Practices in Anticoagulation Therapy in Patients with Venous Thromboembolism Rajat Deo, MD, MTR Director of Translational Research in Cardiac Arrhythmias Division of Cardiovascular Medicine
More informationIndications of Anticoagulants; Which Agent to Use for Your Patient? Marc Carrier MD MSc FRCPC Thrombosis Program Ottawa Hospital Research Institute
Indications of Anticoagulants; Which Agent to Use for Your Patient? Marc Carrier MD MSc FRCPC Thrombosis Program Ottawa Hospital Research Institute Disclosures Research Support/P.I. Employee Leo Pharma
More informationWhat You Should Know
1 New 2018 ASH Clinical Practice Guidelines on Venous Thromboembolism: What You Should Know New 2018 ASH Clinical Practice Guidelines on Venous Thromboembolism: What You Should Know The American Society
More informationVenous Thromboembolic Events (VTEs)
Venous Thromboembolic Events (VTEs) This Infosheet explains what a VTE is, what the causes and risk factors for VTEs are, the symptoms of a VTE, how they can be treated and some tips for self-management.
More informationControversies in Venous Thromboembolism
Controversies in Venous Thromboembolism Menaka Pai, BSc MSc MD FRCPC Assistant Professor, Department of Medicine, McMaster University Associate Member, Department of Pathology and Molecular Medicine, McMaster
More informationChallenges in Anticoagulation and Thromboembolism
Challenges in Anticoagulation and Thromboembolism Ethan Cumbler M.D. Assistant Professor of Medicine Hospitalist Medicine Section University of Colorado Denver May 2010 No Conflicts of Interest Objectives
More informationCOMMITTEE FOR PROPRIETARY MEDICINAL PRODUCTS (CPMP)
The European Agency for the Evaluation of Medicinal Products Evaluation of Medicines for Human Use London, 16 December 1999 COMMITTEE FOR PROPRIETARY MEDICINAL PRODUCTS (CPMP) NOTE FOR GUIDANCE ON CLINICAL
More informationCover Page. The handle holds various files of this Leiden University dissertation.
Cover Page The handle http://hdl.handle.net/188/20915 holds various files of this Leiden University dissertation. Author: Flinterman, Linda Elisabeth Title: Risk factors for a first and recurrent venous
More informationVascular Protection: Preventing Thrombotic Complications of VTE and PAD
Vascular Protection: Preventing Thrombotic Complications of VTE and PAD Thursday, October 11, 2018, 2:00pm ET Guest Speakers: Geoff Barnes, MD Scott Damrauer, MD Moderators: Tracy Minichiello, MD; Sara
More informationGenetic Tests for the Better Outcome of VTE? 서울대학교병원혈액종양내과윤성수
Genetic Tests for the Better Outcome of VTE? 서울대학교병원혈액종양내과윤성수 Thrombophilia A hereditary or acquired disorder predisposing to thrombosis Questions Why should we test? Who should we test For what disorders?
More informationPulmonary Embolism. Pulmonary Embolism. Pulmonary Embolism. PE - Clinical
Pulmonary embolus - a practical approach to investigation and treatment Sam Janes Wellcome Senior Fellow and Respiratory Physician, University College London Background Diagnosis Treatment Common: 50 cases
More informationIcd 10 code for deep venous
Icd 10 code for deep venous thrombosis prophylaxis The Borg System is 100 % Icd 10 code for deep venous thrombosis prophylaxis PE. Pulmonary Embolus. F-10a Factor 10a Inhibitors. PH. Pulmonary. Hypertension.
More informationManifestation of Antiphospholipid Syndrome among Saudi patients :examining the applicability of sapporo Criteria
Manifestation of Antiphospholipid Syndrome among Saudi patients :examining the applicability of sapporo Criteria Farjah H AlGahtani Associate professor,md,mph Leukemia,Lymphoma in adolescent,thromboembolic
More information10/24/2013. Heparin-Induced Thrombocytopenia (HIT) Anticoagulation Management in ECMO Therapy:
Anticoagulation Management in ECMO Therapy: Heparin-Induced (HIT) Michael H. Creer, MD Professor of Pathology Director, Clinical Laboratories, Medical Co- Director, Hematopathology and Chief, Division
More informationMisunderstandings of Venous thromboembolism prophylaxis
Misunderstandings of Venous thromboembolism prophylaxis Veerendra Chadachan Senior Consultant Dept of General Medicine (Vascular Medicine and Hypertension) Tan Tock Seng Hospital, Singapore Case scenario
More informationPradaxa (dabigatran)
Pradaxa (dabigatran) Policy Number: 5.01.574 Last Review: 7/2018 Origination: 6/2014 Next Review: 7/2019 LoB: ACA Policy Blue Cross and Blue Shield of Kansas City (Blue KC) will provide coverage for Pradaxa
More information