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Platelet Count and Major Bleeding in Patients Receiving Vitamin K Antagonists for Acute Venous Thromboembolism, Findings From Real World Clinical Practice
Giorgi-Pierfranceschi, Mateo (Ospedale Val d'Arda (Piacenza, Itàlia))
Di Micco, Pierpaolo (Ospedale Buon Consiglio (Nàpols, Itàlia))
Cattabiani, Chiara (Ospedale Val d'Arda (Piacenza, Itàlia))
Guida, Anna (San Giovanni di Dio Ruggi d'Aragona (Salern, Itàlia))
Pagán, Barbara (Hospital Universitario HM Sanchinarro (Madrid))
Morales, María del Valle (Hospital del Tajo (Madrid))
Salgado, Estuardo (Clínica La Merced (Quito, Equador))
Suriñach, Jose María (Hospital Universitari Vall d'Hebron)
Tolosa, Carles (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Monreal, Manuel (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
RIETE Investigators

Date: 2015
Abstract: The outcome of patients with acute venous thromboembolism (VTE) and abnormal platelet count (PlC) at baseline has not been consistently studied. In real-world clinical practice, a number of patients with abnormal PlC receive vitamin K antagonists (VKAs) to treat acute VTE despite their higher risk of bleeding. We used the Registro Informatizado de Enfermedad TromboEmbólica registry database to compare the rate of major bleeding in patients receiving VKA for long-term therapy of acute VTE according to PlC levels at baseline. Patients were categorized as having very low (<100,000/μL), low (100,000-150,000/μL), normal (150,000-300,000/μL), high (300,000-450,000/μL), or very high (>450,000/μL) PlC at baseline. Of 55,369 patients recruited as of January 2015, 37,000 (67%) received long-term therapy with VKA. Of these, 611 patients (1. 6%) had very low PlC, 4006 (10. 8%) had low PlC, 25,598 (69%) had normal PlC, 5801 (15. 6%) had high PlC, and 984 (2. 6%) had very high PlC at baseline. During the course of VKA therapy (mean, 192 days), there were no differences in the duration or intensity (as measured by international normalized ratio levels) of treatment between subgroups. The rate of major bleeding was 3. 6%, 2. 1%, 1. 9%, 2. 1%, and 3. 7%, respectively, and the rate of fatal bleeding was 0. 98%, 0. 17%, 0. 29%, 0. 34%, and 0. 50%, respectively. Patients with very low or very high PlC levels were more likely to have severe comorbidities. We found a nonlinear "U-shaped" relationship between PlC at baseline and major bleeding during therapy with VKA for VTE. Consistent alteration of PlC values at baseline suggested a greater frailty.
Rights: Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades. Creative Commons
Language: Anglès
Document: article ; recerca ; publishedVersion
Published in: Medicine, Vol. 94 Núm. 47 (november 2015) , ISSN 1536-5964

DOI: 10.1097/MD.0000000000001915
PMID: 26632687

8 p, 355.6 KB

The record appears in these collections:
Research literature > UAB research groups literature > Research Centres and Groups (scientific output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Articles > Research articles
Articles > Published articles

 Record created 2016-07-25, last modified 2020-09-27

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