Ageno, Walter and Casella, Ivan B. and Chee, Kok Han and Schellong, Sebastian and Schulman, Sam and Singer, Daniel E. and Desch, Marc and Tang, Wenbo and Voccia, Isabelle and Zint, Kristina and Goldhaber, Samuel Z. (2021) Profile of patients diagnosed with acute venous thromboembolism in routine practice according to age and renal function: RE-COVERY DVT/PE study. Journal of Thrombosis And Thrombolysis, 51 (3). pp. 561-570. ISSN 0929-5305, DOI https://doi.org/10.1007/s11239-020-02239-9.
Full text not available from this repository.Abstract
In randomized clinical trials (RCTs) of nonvitamin K antagonist oral anticoagulants (NOACs) for acute venous thromboembolism (VTE), similar to 12-13% of patients were elderly and similar to 26% had mild-to-moderate renal impairment. Observational studies are not restricted by the selection and treatment criteria of RCTs. In this ancillary analysis of the RE-COVERY DVT/PE global observational study, we aimed to describe patient characteristics, comorbidities, and anticoagulant therapy for subgroups of age (< or >= 75 years) and renal impairment (creatinine clearance CrCl; estimated with Cockcroft-Gault formula] < 30 severe], 30 to < 50 moderate], 50 to < 80 mild], >= 80 normal] mL/min). Of 6095 eligible patients, 25.3% were aged >= 75 years; 38.2% (1605/4203 with CrCl values) had mild-to-moderate renal impairment. Comorbidities were more common in older patients (73.9% aged >= 75 vs. 58.1% < 75 years) and in those with mild or moderate versus no renal impairment (75.9%, 80.9%, and 59.3%, respectively). At hospital discharge or 14 days after diagnosis (whichever was later), most patients (53.7% and 55.1%, respectively) in both age groups received NOACs; 20.8% and 23.4%, respectively, received vitamin K antagonists, 19.0% and 21.8% parenteral therapy, 2.3% and 3.8% other anticoagulant treatments. Use of NOACs decreased with worsening renal impairment (none 58.5%, moderate 49.6%, severe 25.7%) and, in younger versus older patients with moderate renal impairment (33.1% vs. 56.1%). In routine practice, there are more elderly and renally impaired patients with VTE than represented in RCTs. Decreasing renal function, but not older age, was associated with less NOAC use. Clinical Trial Registration:. Unique identifier: NCT02596230. Graphic abstract Decreasing renal function, particularly in the subgroup with CrCl < 30 mL/min, but not older age, was associated with less use of nonvitamin K antagonist oral anticoagulants (NOACs). Nevertheless, more than half of the older patients with moderate renal impairment received a NOAC as their oral anticoagulant.
| Item Type: | Article |
|---|---|
| Funders: | Boehringer Ingelheim |
| Uncontrolled Keywords: | Anticoagulation; Elderly; Nonvitamin K antagonist oral anticoagulant; Renal function; Vitamin K antagonist |
| Subjects: | R Medicine > R Medicine (General) |
| Divisions: | Faculty of Medicine > Medicine Department |
| Depositing User: | Ms Zaharah Ramly |
| Date Deposited: | 13 Sep 2022 08:01 |
| Last Modified: | 13 Sep 2022 08:01 |
| URI: | http://eprints.um.edu.my/id/eprint/34413 |
Actions (login required)
 |
View Item |
