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学科主题: 临床医学
题名:
Predicting the Risk of Venous Thromboembolism in Patients Hospitalized With Heart Failure
作者: Mebazaa, Alexandre1,2; Spiro, Theodore E.3; Buller, Harry R.4; Haskell, Lloyd5; Hu, Dayi6; Hull, Russell7; Merli, Geno8; Schellong, Sebastian W.9; Spyropoulos, Alex C.10; Tapson, Victor F.11; De Sanctis, Yoriko3; Cohen, Alexander T.12
关键词: heart failure ; natriuretic peptides ; thrombosis
刊名: CIRCULATION
发表日期: 2014-07-29
DOI: 10.1161/CIRCULATIONAHA.113.003126
卷: 130, 期:5, 页:410-418
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Cardiac & Cardiovascular Systems ; Peripheral Vascular Disease
研究领域[WOS]: Cardiovascular System & Cardiology
关键词[WOS]: NATRIURETIC PEPTIDE ; MEDICAL PATIENTS ; PULMONARY-EMBOLISM ; CARDIOVASCULAR-DISEASE ; EUROPEAN-SOCIETY ; ACUTELY ILL ; NT-PROBNP ; ASSOCIATION ; EVENTS ; THROMBOPROPHYLAXIS
英文摘要:

Background-Whether heart failure (HF) increases the risk of venous thromboembolism (VTE) is not well established. In the phase III MAGELLAN (Multicenter, rAndomized, parallel Group Efficacy and safety study for the prevention of venous thromboembolism in hospitalized medically iLL patients comparing rivaroxabAN with enoxaparin) trial, extended-duration rivaroxaban was compared with standard-duration enoxaparin followed by placebo for VTE prevention in 8101 hospitalized acutely ill patients with or without HF. The aim of this analysis was to evaluate the relationship between HF severity and the risk of VTE in MAGELLAN patients.

Methods and Results-Hospitalized patients diagnosed with HF were included according to New York Heart Association class III or IV at admission (n=2593). HF severity was determined by N-terminal probrain natriuretic peptide (NT-proBNP) plasma concentrations (median 1904 pg/mL). Baseline plasma D-dimer concentrations ranged from 0.6 to 1.7 g/L for the less and more severe HF subgroups. Patients with more severe HF had a greater incidence of VTE versus patients with less severe HF, with a significant trend up to Day 10 (4.3% versus 2.2%; P=0.0108) and Day 35 (7.2% versus 4.1%; P=0.0150). Multivariable analysis confirmed that NT-proBNP concentration was associated with VTE risk up to Day 10 (P=0.017) and D-dimer concentration with VTE risk up to Day 35 (P=0.005). The association between VTE risk and HF severity that was observed in the enoxaparin/placebo group was not seen in the extended-duration rivaroxaban group.

Conclusions-Patients with more severe HF, as defined by high NT-proBNP plasma concentration, were at increased risk of VTE. NT-proBNP may be useful to identify high short-term risk, whereas elevated D-dimer may be suggestive of high midterm risk.

语种: 英语
项目资助者: Bayer HealthCare Pharmaceuticals ; Janssen Research &amp ; Development, LLC
WOS记录号: WOS:000340366900012
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/62191
Appears in Collections:北京大学第二临床医学院_期刊论文

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作者单位: 1.Thomas Jefferson Med Ctr, Philadelphia, PA USA
2.Dresden Friedrichstadt Hosp, Dresden, Germany
3.Duke Univ, Med Ctr, Durham, NC USA
4.Kings Coll Hosp London, London, England
5.Peking Univ, Peoples Hosp, Beijing 100871, Peoples R China
6.Foothills Prov Gen Hosp, Calgary, AB T2N 2T9, Canada
7.Bayer HealthCare Pharmaceut Inc, Montville, NJ USA
8.Janssen Res & Dev LLC, Raritan, NJ USA
9.Univ Paris Diderot, PRES Sorbonne Paris Cite, Paris, France
10.St Louis Lariboisiere Univ Hosp, INSERM, U942, Dept Anesthesiol & Crit Care Med, F-75475 Paris 10, France
11.Univ Amsterdam, Acad Med Ctr, NL-1105 AZ Amsterdam, Netherlands
12.Hofstra North Shore LIJ Sch Med, Manhasset, NY USA

Recommended Citation:
Mebazaa, Alexandre,Spiro, Theodore E.,Buller, Harry R.,et al. Predicting the Risk of Venous Thromboembolism in Patients Hospitalized With Heart Failure[J]. CIRCULATION,2014,130(5):410-418.
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