Thrombin Generation Is Associated with Venous Thromboembolism Recurrence, but Not with Major Bleeding and Death in the Elderly: A Prospective Multicenter Cohort Study.
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BORIS DOI
Date of Publication
September 19, 2023
Publication Type
Article
Author
Rütsche, Sereina | |
Quarroz, Claudia | |
Marie, Méan | |
Righini, Marc | |
Staub, Daniel | |
Beer, Juerg H | |
Frauchiger, Beat | |
Osterwalder, Joseph | |
Kucher, Nils | |
Matter, Christian M | |
Husmann, Marc | |
Banyai, Martin | |
Aschwanden, Markus | |
Mazzolai, Lucia | |
Hugli, Olivier | |
Series
Journal of clinical medicine
ISSN or ISBN (if monograph)
2077-0383
Publisher
MDPI
Language
English
Publisher DOI
PubMed ID
37762997
Description
It is currently unknown whether thrombin generation is associated with venous thromboembolism (VTE) recurrence, major bleeding, or mortality in the elderly. Therefore, our aim was to prospectively study the association between thrombin generation and VTE recurrence, major bleeding, and mortality in elderly patients with acute VTE. Consecutive patients aged ≥65 years with acute VTE were followed for 2 years, starting from 1 year after the index VTE. Primary outcomes were VTE recurrence, major bleeding, and mortality. Thrombin generation was assessed in 551 patients 1 year after the index VTE. At this time, 59% of the patients were still anticoagulated. Thrombin generation was discriminatory for VTE recurrence, but not for major bleeding and mortality in non-anticoagulated patients. Moreover, peak ratio (adjusted subhazard ratio 4.09, 95% CI, 1.12-14.92) and normalized peak ratio (adjusted subhazard ratio 2.18, 95% CI, 1.28-3.73) in the presence/absence of thrombomodulin were associated with VTE recurrence, but not with major bleeding and mortality after adjustment for potential confounding factors. In elderly patients, thrombin generation was associated with VTE recurrence, but not with major bleeding and/or mortality. Therefore, our study suggests the potential usefulness of thrombin generation measurement after anticoagulation completion for VTE to help identify among elderly patients those at higher risk of VTE recurrence.
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File | File Type | Format | Size | License | Publisher/Copright statement | Content | |
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jcm-12-06050.pdf | text | Adobe PDF | 2.1 MB | Attribution (CC BY 4.0) | published |