Wan, T., Rodger, M., Zeng, W., Robin, P., Righini, M., Kovacs, M. J., Tan, M., Carrier, M., Kahn, S. R., Wells, P. S., Anderson, D. R., Chagnon, I., Solymoss, S., Crowther, M., White, R. H., Vickars, L., Bazarjani, S., & Le Gal, G. (2018). Residual pulmonary embolism as a predictor for recurrence after a first unprovoked episode: Results from the REVERSE cohort study. Thrombosis Research, 162, 104-109. https://doi.org/10.1016/j.thromres.2017.11.020
Residual pulmonary embolism as a predictor for recurrence after a first unprovoked episode: Results from the REVERSE cohort study. / Wan, Tony; Rodger, Marc; Zeng, Wanzhen et al.
Dans:
Thrombosis Research, Vol. 162, 02.2018, p. 104-109.
Résultat de recherche: Article › examen par les pairs
Wan, T, Rodger, M, Zeng, W, Robin, P, Righini, M, Kovacs, MJ, Tan, M, Carrier, M, Kahn, SR, Wells, PS, Anderson, DR, Chagnon, I, Solymoss, S, Crowther, M, White, RH, Vickars, L, Bazarjani, S & Le Gal, G 2018, 'Residual pulmonary embolism as a predictor for recurrence after a first unprovoked episode: Results from the REVERSE cohort study', Thrombosis Research, vol. 162, pp. 104-109. https://doi.org/10.1016/j.thromres.2017.11.020
Wan T, Rodger M, Zeng W, Robin P, Righini M, Kovacs MJ et al. Residual pulmonary embolism as a predictor for recurrence after a first unprovoked episode: Results from the REVERSE cohort study. Thrombosis Research. 2018 févr.;162:104-109. doi: 10.1016/j.thromres.2017.11.020
Wan, Tony ; Rodger, Marc ; Zeng, Wanzhen et al. / Residual pulmonary embolism as a predictor for recurrence after a first unprovoked episode : Results from the REVERSE cohort study. Dans: Thrombosis Research. 2018 ; Vol. 162. pp. 104-109.
@article{5c794a7adc5d487d9239e3a34015b7d4,
title = "Residual pulmonary embolism as a predictor for recurrence after a first unprovoked episode: Results from the REVERSE cohort study",
abstract = "Background: The optimal duration of oral anticoagulant therapy after a first, unprovoked venous thromboembolism is controversial due to tightly balanced risks and benefits of indefinite anticoagulation. Risk stratification tools may assist in decision making. Objectives: We sought to determine the relationship between residual pulmonary embolism assessed by baseline ventilation-perfusion scan after completion of 5–7 months of oral anticoagulant therapy and the risk of recurrent venous thromboembolism in patients with the first episode of unprovoked pulmonary embolism. Methods: We conducted a multicentre prospective cohort study of participants with a first, unprovoked venous thromboembolism enrolled after the completion of 5–7 months of oral anticoagulation therapy. The participants completed a mean 18-month follow-up. Participants with pulmonary embolism had baseline ventilation-perfusion scan before discontinuation of oral anticoagulant therapy and the percentage of vascular obstruction on baseline ventilation-perfusion scan was determined. During follow-up after discontinuation of oral anticoagulant therapy, all episodes of suspected recurrent venous thromboembolism were independently adjudicated with reference to baseline imaging. Measurements and main results: During follow-up, 24 of 239 (10.0%) participants with an index event of isolated pulmonary embolism or pulmonary embolism associated with deep vein thrombosis and central assessment of percentage of vascular obstruction on baseline ventilation-perfusion scan had confirmed recurrent venous thromboembolism. As compared to participants with no residual pulmonary embolism on baseline ventilation-perfusion scan, the hazard ratio for recurrent venous thromboembolism was 2.0 (95% CI 0.5–7.3) for participants with percentage of vascular obstruction of 0.1%–4.9%, 2.1 (95% CI 0.5–7.8) for participants with percentage vascular obstruction of 5.0%–9.9% and 5.3 (95% CI 1.8–15.4) for participants with percentage vascular obstruction greater than or equal to 10%. Conclusions: Residual pulmonary embolism assessed by pulmonary vascular obstruction on baseline ventilation-perfusion performed after 5–7 months of oral anticoagulant therapy for the first episode of unprovoked pulmonary embolism was associated with a statistically significant higher risk of subsequent recurrent venous thromboembolism. Percentage of pulmonary vascular obstruction assessment by ventilation-perfusion scans maybe a useful tool to help guide the duration of oral anticoagulant therapy after a first unprovoked pulmonary embolism. Trial registration: Registered at www.clinicaltrials.gov identifier: NCT00261014.",
author = "Tony Wan and Marc Rodger and Wanzhen Zeng and Philippe Robin and Marc Righini and Kovacs, {Michael J.} and Melanie Tan and Marc Carrier and Kahn, {Susan R.} and Wells, {Philip S.} and Anderson, {David R.} and Isabelle Chagnon and Susan Solymoss and Mark Crowther and White, {Richard H.} and Linda Vickars and Sadri Bazarjani and {Le Gal}, Gr{\'e}goire",
note = "Funding Information: This study was funded by the Canadian Institutes of Health Research (Grant #MOP 64319) and BioMerieux (through an unrestricted research grant). GLG holds a University of Ottawa Department of Medicine Chair in Diagnosis of Venous Thromboembolism, a CP Has Heart Clinician-Scientist award from the Heart and Stroke Foundation of Ontario, and an Early Research Award from the Government of Ontario. Publisher Copyright: {\textcopyright} 2017 Elsevier Ltd",
year = "2018",
month = feb,
doi = "10.1016/j.thromres.2017.11.020",
language = "English",
volume = "162",
pages = "104--109",
journal = "Thrombosis Research",
issn = "0049-3848",
publisher = "Elsevier Limited",
}
TY - JOUR
T1 - Residual pulmonary embolism as a predictor for recurrence after a first unprovoked episode
T2 - Results from the REVERSE cohort study
AU - Wan, Tony
AU - Rodger, Marc
AU - Zeng, Wanzhen
AU - Robin, Philippe
AU - Righini, Marc
AU - Kovacs, Michael J.
AU - Tan, Melanie
AU - Carrier, Marc
AU - Kahn, Susan R.
AU - Wells, Philip S.
AU - Anderson, David R.
AU - Chagnon, Isabelle
AU - Solymoss, Susan
AU - Crowther, Mark
AU - White, Richard H.
AU - Vickars, Linda
AU - Bazarjani, Sadri
AU - Le Gal, Grégoire
N1 - Funding Information:
This study was funded by the Canadian Institutes of Health Research (Grant #MOP 64319) and BioMerieux (through an unrestricted research grant). GLG holds a University of Ottawa Department of Medicine Chair in Diagnosis of Venous Thromboembolism, a CP Has Heart Clinician-Scientist award from the Heart and Stroke Foundation of Ontario, and an Early Research Award from the Government of Ontario.
Publisher Copyright:
© 2017 Elsevier Ltd
PY - 2018/2
Y1 - 2018/2
N2 - Background: The optimal duration of oral anticoagulant therapy after a first, unprovoked venous thromboembolism is controversial due to tightly balanced risks and benefits of indefinite anticoagulation. Risk stratification tools may assist in decision making. Objectives: We sought to determine the relationship between residual pulmonary embolism assessed by baseline ventilation-perfusion scan after completion of 5–7 months of oral anticoagulant therapy and the risk of recurrent venous thromboembolism in patients with the first episode of unprovoked pulmonary embolism. Methods: We conducted a multicentre prospective cohort study of participants with a first, unprovoked venous thromboembolism enrolled after the completion of 5–7 months of oral anticoagulation therapy. The participants completed a mean 18-month follow-up. Participants with pulmonary embolism had baseline ventilation-perfusion scan before discontinuation of oral anticoagulant therapy and the percentage of vascular obstruction on baseline ventilation-perfusion scan was determined. During follow-up after discontinuation of oral anticoagulant therapy, all episodes of suspected recurrent venous thromboembolism were independently adjudicated with reference to baseline imaging. Measurements and main results: During follow-up, 24 of 239 (10.0%) participants with an index event of isolated pulmonary embolism or pulmonary embolism associated with deep vein thrombosis and central assessment of percentage of vascular obstruction on baseline ventilation-perfusion scan had confirmed recurrent venous thromboembolism. As compared to participants with no residual pulmonary embolism on baseline ventilation-perfusion scan, the hazard ratio for recurrent venous thromboembolism was 2.0 (95% CI 0.5–7.3) for participants with percentage of vascular obstruction of 0.1%–4.9%, 2.1 (95% CI 0.5–7.8) for participants with percentage vascular obstruction of 5.0%–9.9% and 5.3 (95% CI 1.8–15.4) for participants with percentage vascular obstruction greater than or equal to 10%. Conclusions: Residual pulmonary embolism assessed by pulmonary vascular obstruction on baseline ventilation-perfusion performed after 5–7 months of oral anticoagulant therapy for the first episode of unprovoked pulmonary embolism was associated with a statistically significant higher risk of subsequent recurrent venous thromboembolism. Percentage of pulmonary vascular obstruction assessment by ventilation-perfusion scans maybe a useful tool to help guide the duration of oral anticoagulant therapy after a first unprovoked pulmonary embolism. Trial registration: Registered at www.clinicaltrials.gov identifier: NCT00261014.
AB - Background: The optimal duration of oral anticoagulant therapy after a first, unprovoked venous thromboembolism is controversial due to tightly balanced risks and benefits of indefinite anticoagulation. Risk stratification tools may assist in decision making. Objectives: We sought to determine the relationship between residual pulmonary embolism assessed by baseline ventilation-perfusion scan after completion of 5–7 months of oral anticoagulant therapy and the risk of recurrent venous thromboembolism in patients with the first episode of unprovoked pulmonary embolism. Methods: We conducted a multicentre prospective cohort study of participants with a first, unprovoked venous thromboembolism enrolled after the completion of 5–7 months of oral anticoagulation therapy. The participants completed a mean 18-month follow-up. Participants with pulmonary embolism had baseline ventilation-perfusion scan before discontinuation of oral anticoagulant therapy and the percentage of vascular obstruction on baseline ventilation-perfusion scan was determined. During follow-up after discontinuation of oral anticoagulant therapy, all episodes of suspected recurrent venous thromboembolism were independently adjudicated with reference to baseline imaging. Measurements and main results: During follow-up, 24 of 239 (10.0%) participants with an index event of isolated pulmonary embolism or pulmonary embolism associated with deep vein thrombosis and central assessment of percentage of vascular obstruction on baseline ventilation-perfusion scan had confirmed recurrent venous thromboembolism. As compared to participants with no residual pulmonary embolism on baseline ventilation-perfusion scan, the hazard ratio for recurrent venous thromboembolism was 2.0 (95% CI 0.5–7.3) for participants with percentage of vascular obstruction of 0.1%–4.9%, 2.1 (95% CI 0.5–7.8) for participants with percentage vascular obstruction of 5.0%–9.9% and 5.3 (95% CI 1.8–15.4) for participants with percentage vascular obstruction greater than or equal to 10%. Conclusions: Residual pulmonary embolism assessed by pulmonary vascular obstruction on baseline ventilation-perfusion performed after 5–7 months of oral anticoagulant therapy for the first episode of unprovoked pulmonary embolism was associated with a statistically significant higher risk of subsequent recurrent venous thromboembolism. Percentage of pulmonary vascular obstruction assessment by ventilation-perfusion scans maybe a useful tool to help guide the duration of oral anticoagulant therapy after a first unprovoked pulmonary embolism. Trial registration: Registered at www.clinicaltrials.gov identifier: NCT00261014.
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UR - http://www.scopus.com/inward/citedby.url?scp=85041497382&partnerID=8YFLogxK
U2 - 10.1016/j.thromres.2017.11.020
DO - 10.1016/j.thromres.2017.11.020
M3 - Article
C2 - 29224973
AN - SCOPUS:85041497382
SN - 0049-3848
VL - 162
SP - 104
EP - 109
JO - Thrombosis Research
JF - Thrombosis Research
ER -