Independent predictors of poor vitamin K antagonist control in venous thromboembolism patients Data from the EINSTEIN-DVT and PE studiesKooistra, H. A. M., Gebel, M., Sahin, K., Lensing, A. W. A. & Meijer, K., Dec-2015, In : Thrombosis and Haemostasis. 114, 6, p. 1136-1143 8 p.
Research output: Contribution to journal › Article › Academic › peer-review
Vitamin K antagonists (VKA) are used to prevent recurrent disease in patients with venous thromboembolism (VTE). Their efficacy and safety depend on individual time in therapeutic range (iTTR) and variability of International Normalised Ratios (INR). We aimed to identify independent predictors of poor VKA control > 28 days. In a prospective cohort of 3825 VTE patients, separate logistic regression analyses were performed to identify predictors of low iTTR (first quartile) and instability (iTTR median). Subsequently, the association between these predictors and clinical outcomes was investigated. Weight <50 kg (odds ratio [OR]=1.89; 95 % confidence interval [CI] 1.03-3.49), active cancer at baseline (OR=1.52; CI1.05-2.19), secondary VTE (OR=1.42; CI1.20-1.68), and INR <2.0 at stop of double therapy (OR=1.35; CI1.09-1.67) were independent predictors of low iTTR. The first two were also predictive for instability (OR= 1.96; CI1.06-3.63 and OR=1.95; CI1.36-2.80, re-spectively). ORs of early ( 28 days, which showed some similarities but did not fully overlap. Early VKA control was of additional value for prediction of both, but had to be interpreted in the context of VKA type.
|Number of pages||8|
|Journal||Thrombosis and Haemostasis|
|Publication status||Published - Dec-2015|
- Venous thrombosis, vitamin K antagonists, predictors, iTTR, instability, NORMALIZED RATIO VARIABILITY, STABLE INR CONTROL, ATRIAL-FIBRILLATION, ANTICOAGULATION CONTROL, ORAL ANTICOAGULATION, THROMBOTIC EVENTS, SAME-TT2R2 SCORE, WARFARIN, OUTCOMES, QUALITY