Venous Thromboembolism in Patients With Autoimmune Disorders: Findings From the RIETE Registry
Por:
Sada, PR, Lopez-Nunez, JJ, Samperiz, A, Soto, MJ, Pedrajas, JM, Porras, JA, Peris, ML, Debourdeau, P, Pace, F, Monreal, M, Adarraga, MD, Agud, M, Aibar, MA, Alfonso, J, Amado, C, Arcelus, JI, Ballaz, A, Barba, R, Barbagelata, C, Barron, M, Barron-Andres, B, Blanco-Molina, A, Camon, AM, Canas, I, Carrasco, C, Castro, J, Cerda, P, de Ancos, C, del Toro, J, Demelo, P, Diaz-Pedroche, C, Diaz-Peromingo, JA, Diaz-Simon, R, Encabo, M, Escribano, JC, Esposito, F, Falga, C, Farfan, I, Fernandez-Capitan, C, Fernandez-Criado, MC, de Roitegui, KF, Fidalgo, MA, Font, C, Font, L, Furest, I, Garcia, MA, Garcia-Bragado, F, Garcia-Raso, A, Gavin-Blanco, O, Gavin-Sebastian, O, Gayol, MC, Gil-Diaz, A, Gomez, V, Gomez-Cuervo, C, Gonzalez-Martinez, J, Grau, E, Gutierrez, J, Hernandez-Blasco, LM, Iglesias, M, Jara-Palomares, L, Jaras, MJ, Jimenez, D, Jimenez, R, Joya, MD, Jou, I, Lecumberri, R, Lima, J, Llamas, P, Lobo, JL, Lopez-Jimenez, L, Lopez-Miguel, P, Lopez-Nunez, JJ, Lopez-Reyes, R, Lopez-Saez, JB, Lorente, MA, Lorenzo, A, Loring, M, Lumbierres, M, Madridano, O, Maestre, A, Marchena, PJ, del Pozo, MM, Martin-Fortea, P, Martin-Martos, F, Martin-Romero, M, Martinez-Baquerizo, C, Martinez-Garcia, MA, Martinez-Gonzalez, L, Mella, C, Mellado, M, Monreal, M, Montesa, C, Morales, MV, Nieto, JA, Nunez, MJ, Olivares, MC, Olivera, PE, Otalora, S, Otero, R, Panadero-Macia, M, Pedrajas, JM, Pellejero, G, Perez-Ductor, C, Perez-Rus, G, Peris, ML, Porras, JA, Riera-Mestre, A, Rivas, A, Rodriguez-Cobo, A, Rodriguez-Hernandez, A, Rosa, V, Rubio, CM, Ruiz-Artacho, P, Ruiz-Ruiz, J, Ruiz-Sada, P, Sahuquillo, JC, Sala-Sainz, MC, Salgueiro, G, Samperiz, A, Saanchez-Munoz-Torrero, JF, Sancho, T, Soler, S, Suarez, S, Surinach, JM, Tolosa, C, Torres, MI, Trujillo-Santos, J, Uresandi, F, Valle, R, Vela, JR, Vidal, G, Vilar, C, Villares, P, Gutierrez, P, Vazquez, FJ, Vilaseca, A, Vanassche, T, Vandenbriele, C, Verhamme, P, Hirmerova, J, Maly, R, Celis, G, Salgado, E, Benzidia, I, Bertoletti, L, Bura-Riviere, A, Debourdeau, P, Farge-Bancel, D, Helfer, H, Hij, A, Mahe, I, Moustafa, F, Schellong, S, Braester, A, Brenner, B, Tzoran, I, Sharif-Kashani, B, Barillari, G, Bilora, F, Bortoluzzi, C, Brandolin, B, Ceccanti, G, Ciammaichella, M, Dentali, F, Di Micco, P, Imbalzano, E, Landolfi, R, Lessiani, G, Maida, R, Mastroiacovo, D, Pace, F, Pesavento, R, Pomero, F, Prandoni, P, Quintavalla, R, Rocci, A, Siniscalchi, C, Tufano, A, Visona, A, Hong, NV, Zalunardo, B, Gibietis, V, Kigitovica, D, Skride, A, Bosevski, M, Zdraveska, M, Bounameaux, H, Fresa, M, Mazzolai, L, Ney, B, Prandoni, P, Brenner, B, Farge-Bancel, D, Barba, R, Di Micco, P, Bertoletti, L, Schellong, S, Tzoran, I, Reis, A, Bosevski, M, Bounameaux, H, Maly, R, Verhamme, P, Caprini, JA and Bui, HM
Publicada:
1 feb 2020
Ahead of Print:
1 oct 2019
Resumen:
Patients with autoimmune disorders are at an increased risk of venous thromboembolism (VTE), but this association has not been consistently evaluated. We used the RIETE (Registro Informatizado Enfermedad Trombo Embolica) database to compare the rates of VTE recurrences, major bleeding, and death during the course of anticoagulation, according to the presence or absence of autoimmune disorders. Of 71 625 patients with VTE recruited in February 2018, 1800 (2.5%) had autoimmune disorders. Median duration of anticoagulant therapy was slightly longer in patients with autoimmune disorders (median, 190 vs 182 days; P = .001). On multivariable analysis, patients with autoimmune disorders had a similar risk of VTE recurrences (hazard ratio [HR]: 0.93; 95% confidence interval [CI]: 0.68-1.27) or major bleeding (HR: 1.07; 95% CI: 0.82-1.40) and a lower risk to die (HR: 0.66; 95% CI: 0.54-0.81) than those without autoimmune disorders. Patients with giant cell arteritis had the highest rates of major bleeding (8.6 events per 100 patient-years) and the lowest rate of recurrences (zero). In other subgroups, the rates of both events were more balanced. During anticoagulation, patients with or without autoimmune disorders had similar rates of VTE recurrences or major bleeding. However, there were some differences between subgroups of patients with autoimmune disorders.
Filiaciones:
Sada, PR:
Hosp Reina Sofia de Tudela, Dept Internal Med, Navarra, Spain
:
Univ Autonoma Barcelona, Hosp Univ Germans Trias & Pujol, Dept Internal Med, Badalona, Spain
Samperiz, A:
Hosp Reina Sofia de Tudela, Dept Internal Med, Navarra, Spain
Soto, MJ:
Hosp Univ Puerta del Mar, Dept Internal Med, Cadiz, Spain
Pedrajas, JM:
Hosp Clin San Carlos, Dept Internal Med, Madrid, Spain
Porras, JA:
Hosp Univ Joan XXIII Tarragona, Dept Internal Med, Tarragona, Spain
Peris, ML:
CEU Cardenal Herrera Univ, Consorcio Hosp Prov Castellon, Dept Internal Med, Alfara Del Patriarca, Spain
Debourdeau, P:
Inst St Catherine, Dept Support Care Oncol, Avignon, France
Pace, F:
Osped San Camilo, Dept Med Urgenza, Rome, Italy
:
Univ Catolica Murcia, Hosp Germans Trias & Pujol, Dept Internal Med, Murcia, Spain
Monreal, M:
Univ Catolica Murcia, Hosp Germans Trias & Pujol, Dept Internal Med, Murcia, Spain
Samperiz, A:
Hosp Reina Sofia de Tudela, Dept Internal Med, Navarra, Spain
Debourdeau, P:
Inst St Catherine, Dept Support Care Oncol, Avignon, France
Pace, F:
Osped San Camilo, Dept Med Urgenza, Rome, Italy
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