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Vitamin K antagonists versus heparin for the treatment of splanchnic vein thrombosis in the ISTH registry: Results of 12-month follow-up and a propensity score analysis

Riva, N., Ageno, W., Schulman, S., Bang, S. M., Teresa Sartori, M., Grandone, E., Beyer-Westendorf, J., Barillari, G., Di Minno, M. N. D., Duce, R., Malato, A., Santoro, R., Poli, D., Verhamme, P., Martinelli, I., Kamphuisen, P., Alatri, A., Oh, D., D'Amico, E. A., Rezende, S. M., Becattini, C., Bucherini, E. & Dentali, F., 1-Nov-2014, In : Thrombosis Research. 134, p. 34-35 2 p.

Research output: Contribution to journalArticleAcademicpeer-review

  • N. Riva
  • W. Ageno
  • S. Schulman
  • S.M. Bang
  • M. Teresa Sartori
  • E. Grandone
  • J. Beyer-Westendorf
  • G. Barillari
  • M.N.D. Di Minno
  • R. Duce
  • A. Malato
  • R. Santoro
  • D. Poli
  • P. Verhamme
  • I. Martinelli
  • P. Kamphuisen
  • A. Alatri
  • D. Oh
  • E.A. D'Amico
  • S.M. Rezende
  • C. Becattini
  • E. Bucherini
  • F. Dentali
Introduction: Splanchnic vein thrombosis [SVT] is a challenging disease, because of the concurrent increased risk of bleeding and potentially lifethreatening complications. We aimed to explore the actual management of SVT in a large prospective cohort and to report clinical outcomes during follow-up. Methods: Consecutive SVT patients were enrolled in a multicenter international registry, from 2008 to 2012. Clinical outcomes (major bleeding; vascular events, defined as venous or arterial thrombosis; mortality) were collected. A propensity score [PS], created from baseline characteristics of patients receiving the two main treatments (different dosages of parenteral anticoagulants vs vitamin K antagonists [VKAs]), was used to estimate the effect of therapeutic strategies. We here report the results of the 12-month follow-up. Results: 613 patients were enrolled; mean age 53.1±14.8 years; 62.6% males. Initially, 143 patients were not anticoagulated; 175 received parenteral anticoagulants only (mean duration 6.28±4.21 months) and 295 started VKAs (9.67±3.53 months). Major bleeding occurred in 25 patients, 16 on treatment (4.53/100 patientyears [pt-y]) and 9 off treatment (5.45/100 pt-y); vascular events in 47 patients, 27 and 20 (7.93/100 pt-y vs 11.85/100 pt-y); death in 79 patients, 44 and 35 (12.35/100 pt-y vs 20.30/100 pt-y). Solid cancer, ascites, anemia and thrombocytopenia were inversely associated with the prescription of VKAs in a binary logistic regression. Using PS based on these variables, we matched 102 patients treated with VKAs with 102 patients treated with parenteral anticoagulants. Major bleeding occurred in 5.88% vs 0.98% for VKAs and heparin, respectively; vascular events in 2.94% vs 8.82%; mortality in 5.88% vs 18.63%. Conclusions: In our cohort of SVT patients, the incidence of vascular and bleeding events at 1-year follow-up was relevant. Although the PS matching did not allow for a complete balance of heterogeneity, in designated patients VKA treatment appeared to be sufficiently safe.
Original languageEnglish
Pages (from-to)34-35
Number of pages2
JournalThrombosis Research
Volume134
Publication statusPublished - 1-Nov-2014

    Keywords

  • heparin, antivitamin K, anticoagulant agent, vein thrombosis, register, follow up, propensity score, society, hemostasis, thrombosis, human, patient, bleeding, mortality, solid, death, artery thrombosis, neoplasm, logistic regression analysis, prescription, thrombocytopenia, anemia, ascites, male, risk

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