Long-term death and recurrence in patients with acute venous thromboembolism: The MASTER registry

Melina Verso, Giancarlo Agnelli, Walter Ageno, Davide Imberti, Marco Moia, Gualtiero Palareti, Riccardo Pistelli, Valeria Cantone

Research output: Contribution to journalArticle

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Abstract

Background: The long-term clinical outcome of VTE has been essentially assessed in cohorts of selected patients. The aim of this multicenter registry was to prospectively assess the long-term clinical outcome in a cohort of unselected patients with objectively confirmed acute VTE. Materials and Methods: Death and VTE recurrence at 24 months were the main study outcomes. Univariate and multivariate survival analyses were performed according to the Kaplan-Meyer and Cox proportional hazard model, respectively. Results: 2119 patients with acute VTE were included in the registry: 1541 (72.7%) with deep vein thrombosis, 206 (9.7%) with pulmonary embolism and 372 (17.6%) with both. Information about death was available in 2021 patients (95.4%) and about recurrence in 1988 patients (93.8%). 167 patients (4.55% patient-year) died during follow-up. After adjusting for age, cancer (Hazard ratio [HR]: 7.2; 95%CI 4.8-10.8), long-term heparin treatment (HR: 2.5; 95%CI 1.8-3.5), in-hospital management of VTE (HR: 2.0; 95%CI 1.3-3.0), and ileo-caval thrombosis (HR: 1.7; 95%CI 1.2-2.4) were found to be independent predictors of death. 124 (3.63% patient-year) patients had a VTE recurrence during follow-up. In-hospital management of VTE (HR: 1.8; 95%CI 1.2-2.9), male gender (HR: 1.7; 95%CI 1.2-2.4) were independent risk factors for recurrent VTE. Cancer (HR: 1.6; 95%CI 1.0-2.8) showed a trend for increased risk of VTE recurrence (p = 0.056). The reported rate of major bleeding was 2.5%. Conclusions: In a large cohort of unselected VTE patients, cancer, ileo-caval thrombosis, long-term heparin treatment and in-hospital management were associated with increased mortality during long-term follow-up. In-hospital management, male gender were associated with an increased risk of VTE recurrence.

Original languageEnglish
Pages (from-to)369-373
Number of pages5
JournalThrombosis Research
Volume130
Issue number3
DOIs
Publication statusPublished - Sep 2012

Fingerprint

Venous Thromboembolism
Registries
Recurrence
Safety Management
Venae Cavae
Heparin
Thrombosis
Neoplasms
Survival Analysis
Pulmonary Embolism
Proportional Hazards Models
Venous Thrombosis
Multivariate Analysis
Outcome Assessment (Health Care)
Hemorrhage
Mortality

Keywords

  • Death
  • Deep Venous Thrombosis
  • Long-Term Follow Up
  • Pulmonary Embolism
  • Recurrent VTE
  • Venous Thromboembolism

ASJC Scopus subject areas

  • Hematology

Cite this

Long-term death and recurrence in patients with acute venous thromboembolism : The MASTER registry. / Verso, Melina; Agnelli, Giancarlo; Ageno, Walter; Imberti, Davide; Moia, Marco; Palareti, Gualtiero; Pistelli, Riccardo; Cantone, Valeria.

In: Thrombosis Research, Vol. 130, No. 3, 09.2012, p. 369-373.

Research output: Contribution to journalArticle

Verso, M, Agnelli, G, Ageno, W, Imberti, D, Moia, M, Palareti, G, Pistelli, R & Cantone, V 2012, 'Long-term death and recurrence in patients with acute venous thromboembolism: The MASTER registry', Thrombosis Research, vol. 130, no. 3, pp. 369-373. https://doi.org/10.1016/j.thromres.2012.04.003
Verso, Melina ; Agnelli, Giancarlo ; Ageno, Walter ; Imberti, Davide ; Moia, Marco ; Palareti, Gualtiero ; Pistelli, Riccardo ; Cantone, Valeria. / Long-term death and recurrence in patients with acute venous thromboembolism : The MASTER registry. In: Thrombosis Research. 2012 ; Vol. 130, No. 3. pp. 369-373.
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abstract = "Background: The long-term clinical outcome of VTE has been essentially assessed in cohorts of selected patients. The aim of this multicenter registry was to prospectively assess the long-term clinical outcome in a cohort of unselected patients with objectively confirmed acute VTE. Materials and Methods: Death and VTE recurrence at 24 months were the main study outcomes. Univariate and multivariate survival analyses were performed according to the Kaplan-Meyer and Cox proportional hazard model, respectively. Results: 2119 patients with acute VTE were included in the registry: 1541 (72.7{\%}) with deep vein thrombosis, 206 (9.7{\%}) with pulmonary embolism and 372 (17.6{\%}) with both. Information about death was available in 2021 patients (95.4{\%}) and about recurrence in 1988 patients (93.8{\%}). 167 patients (4.55{\%} patient-year) died during follow-up. After adjusting for age, cancer (Hazard ratio [HR]: 7.2; 95{\%}CI 4.8-10.8), long-term heparin treatment (HR: 2.5; 95{\%}CI 1.8-3.5), in-hospital management of VTE (HR: 2.0; 95{\%}CI 1.3-3.0), and ileo-caval thrombosis (HR: 1.7; 95{\%}CI 1.2-2.4) were found to be independent predictors of death. 124 (3.63{\%} patient-year) patients had a VTE recurrence during follow-up. In-hospital management of VTE (HR: 1.8; 95{\%}CI 1.2-2.9), male gender (HR: 1.7; 95{\%}CI 1.2-2.4) were independent risk factors for recurrent VTE. Cancer (HR: 1.6; 95{\%}CI 1.0-2.8) showed a trend for increased risk of VTE recurrence (p = 0.056). The reported rate of major bleeding was 2.5{\%}. Conclusions: In a large cohort of unselected VTE patients, cancer, ileo-caval thrombosis, long-term heparin treatment and in-hospital management were associated with increased mortality during long-term follow-up. In-hospital management, male gender were associated with an increased risk of VTE recurrence.",
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AU - Verso, Melina

AU - Agnelli, Giancarlo

AU - Ageno, Walter

AU - Imberti, Davide

AU - Moia, Marco

AU - Palareti, Gualtiero

AU - Pistelli, Riccardo

AU - Cantone, Valeria

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N2 - Background: The long-term clinical outcome of VTE has been essentially assessed in cohorts of selected patients. The aim of this multicenter registry was to prospectively assess the long-term clinical outcome in a cohort of unselected patients with objectively confirmed acute VTE. Materials and Methods: Death and VTE recurrence at 24 months were the main study outcomes. Univariate and multivariate survival analyses were performed according to the Kaplan-Meyer and Cox proportional hazard model, respectively. Results: 2119 patients with acute VTE were included in the registry: 1541 (72.7%) with deep vein thrombosis, 206 (9.7%) with pulmonary embolism and 372 (17.6%) with both. Information about death was available in 2021 patients (95.4%) and about recurrence in 1988 patients (93.8%). 167 patients (4.55% patient-year) died during follow-up. After adjusting for age, cancer (Hazard ratio [HR]: 7.2; 95%CI 4.8-10.8), long-term heparin treatment (HR: 2.5; 95%CI 1.8-3.5), in-hospital management of VTE (HR: 2.0; 95%CI 1.3-3.0), and ileo-caval thrombosis (HR: 1.7; 95%CI 1.2-2.4) were found to be independent predictors of death. 124 (3.63% patient-year) patients had a VTE recurrence during follow-up. In-hospital management of VTE (HR: 1.8; 95%CI 1.2-2.9), male gender (HR: 1.7; 95%CI 1.2-2.4) were independent risk factors for recurrent VTE. Cancer (HR: 1.6; 95%CI 1.0-2.8) showed a trend for increased risk of VTE recurrence (p = 0.056). The reported rate of major bleeding was 2.5%. Conclusions: In a large cohort of unselected VTE patients, cancer, ileo-caval thrombosis, long-term heparin treatment and in-hospital management were associated with increased mortality during long-term follow-up. In-hospital management, male gender were associated with an increased risk of VTE recurrence.

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KW - Death

KW - Deep Venous Thrombosis

KW - Long-Term Follow Up

KW - Pulmonary Embolism

KW - Recurrent VTE

KW - Venous Thromboembolism

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