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Marin-Romero S, Ballaz-Quincoces A, Gómez-Cuervo C, Marchena-Yglesias PJ, Lopez-Miguel P, Francisco-Albesa I, Pedrajas-Navas JM, Lumbierres M, Aibar-Arregui MA, Bosco Lopez-Saez J, Perez-Pinar M, Baeza-Martinez C, Riera-Mestre A, Peris-Sifre M, Porras-Ledantes JA, Criado-Garcia J, Elias-Hernandez T, Otero R, Barca-Hernando M, Muriel A, Klok FA, Jara-Palomares L. Symptom-related screening programme for early detection of chronic thromboembolic pulmonary hypertension after acute pulmonary embolism: the SYSPPE study. Thorax 2024; 79:144-152. [PMID: 38050187 PMCID: PMC10850838 DOI: 10.1136/thorax-2023-220580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 11/16/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND Chronic thromboembolic pulmonary hypertension (CTEPH) is the most severe long-term complication of acute pulmonary embolism (PE). We aimed to evaluate the impact of a symptom screening programme to detect CTEPH in PE survivors. METHODS This was a multicentre cohort study of patients diagnosed with acute symptomatic PE between January 2017 and December 2018 in 16 centres in Spain. Patients were contacted by phone 2 years after the index PE diagnosis. Those with dyspnoea corresponding to a New York Heart Association (NYHA)/WHO scale≥II, visited the outpatient clinic for echocardiography and further diagnostic tests including right heart catheterisation (RHC). The primary outcome was the new diagnosis of CTEPH confirmed by RHC. RESULTS Out of 1077 patients with acute PE, 646 were included in the symptom screening. At 2 years, 21.8% (n=141) reported dyspnoea NYHA/WHO scale≥II. Before symptom screening protocol, five patients were diagnosed with CTEPH following routine care. In patients with NYHA/WHO scale≥II, after symptom screening protocol, the echocardiographic probability of pulmonary hypertension (PH) was low, intermediate and high in 76.6% (n=95), 21.8% (n=27) and 1.6% (n=2), respectively. After performing additional diagnostic test in the latter 2 groups, 12 additional CTEPH cases were confirmed. CONCLUSIONS The implementation of this simple strategy based on symptom evaluation by phone diagnosed more than doubled the number of CTEPH cases. Dedicated follow-up algorithms for PE survivors help diagnosing CTEPH earlier. TRIAL REGISTRATION NUMBER NCT03953560.
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Affiliation(s)
- Samira Marin-Romero
- Respiratory Unit, Medical-Surgical Unit of Respiratory Diseases, Virgen del Rocio University Hospital, Sevilla, Spain
| | | | | | | | | | | | | | - Marina Lumbierres
- Respiratory Department, Arnau de Vilanova University Hospital, Lleida, Spain
| | | | | | | | | | - Antoni Riera-Mestre
- Internal Medicine, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
- Instituto de Investigación Biomédica de Bellvitge, Barcelona, Spain
- Departamento de Ciencias Clínicas, Facultad de Medicina y Ciencias de la Salud, Universitat de Barcelona, Barcelona, Spain
| | - Marisa Peris-Sifre
- Internal Medicine Unit, Hospital Provincial Castellon, Castellon de la Plana, Spain
- CEU Cardenal Herrera University, Moncada, Spain
| | | | | | - Teresa Elias-Hernandez
- Respiratory Unit, Medical-Surgical Unit of Respiratory Diseases, Virgen del Rocio University Hospital, Sevilla, Spain
| | - Remedios Otero
- Respiratory Unit, Medical-Surgical Unit of Respiratory Diseases, Virgen del Rocio University Hospital, Sevilla, Spain
- Center for Biomedical Research in Respiratory Diseases Network (CIBERES), Carlos III Health Institute, Madrid, Spain
| | - Maria Barca-Hernando
- Respiratory Unit, Medical-Surgical Unit of Respiratory Diseases, Virgen del Rocio University Hospital, Sevilla, Spain
| | - Alfonso Muriel
- Center for Biomedical Research in Respiratory Diseases Network (CIBERES), Carlos III Health Institute, Madrid, Spain
- Biostatistics Department, Hospital Universitario Ramon y Cajal, Madrid, Spain
- University of Alcala, Alcala de Henares, Spain
| | - Frederikus A Klok
- Department of Medicine - Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
| | - Luis Jara-Palomares
- Respiratory Unit, Medical-Surgical Unit of Respiratory Diseases, Virgen del Rocio University Hospital, Sevilla, Spain
- Center for Biomedical Research in Respiratory Diseases Network (CIBERES), Carlos III Health Institute, Madrid, Spain
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Barca-Hernando M, Lopez-Ruz S, Marin-Romero S, Elias-Hernandez T, Otero-Candelera R, Jara-Palomares L. Comparison of long-term complications in cancer patients with incidental and acute symptomatic venous thromboembolism. Front Cardiovasc Med 2023; 10:1118385. [PMID: 37273873 PMCID: PMC10237269 DOI: 10.3389/fcvm.2023.1118385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 04/28/2023] [Indexed: 06/06/2023] Open
Abstract
Background Clinical practice guidelines recommend that patients with incidental venous thromboembolism (VTE) receive the same anticoagulant therapy as those with symptomatic VTE. We aimed to compare the rate of complications between cancer patients with incidental and symptomatic VTE through a long-term follow-up cohort. Methods We performed a post hoc analysis of prospective studies of cancer patients with VTE between 2008 and 2019, with the primary outcome of rates of recurrent VTE and clinically relevant bleeding (CRB) in incidental and symptomatic VTE groups. Results In total, 796 patients were included, of which 42.8% had incidental VTE. No significant differences were noted in the rate of recurrent VTE (0.4 per 100 patients/month vs. 0.5 per 100 patients/month; p = 0.313) and in the rate of CRB (0.6 per 100 patients/month vs. 0.5 per 100 patients/month; p = 0.128) between patients with incidental VTE and symptomatic VTE, respectively. At six-month follow-ups, the cumulative incidence of CRB was significantly higher in patients with incidental VTE than that in those with symptomatic VTE (7.9% vs. 4.4%, respectively; OR: 1.8; 95% CI: 1.01-3.2). Conclusion Cancer patients with incidental VTE had similar rates of CRB and VTE recurrence in long-term follow-up compared with patients with symptomatic VTE. At six-month follow-ups, patients with incidental VTE had a higher cumulative incidence of CRB than those with symptomatic VTE.
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Affiliation(s)
- María Barca-Hernando
- Respiratory Department, Medical Surgical Unit of Respiratory Diseases, Hospital Virgen del Rocio, Sevilla, Spain
| | - Sergio Lopez-Ruz
- Respiratory Department, Medical Surgical Unit of Respiratory Diseases, Hospital Virgen del Rocio, Sevilla, Spain
| | - Samira Marin-Romero
- Respiratory Department, Medical Surgical Unit of Respiratory Diseases, Hospital Virgen del Rocio, Sevilla, Spain
| | - Teresa Elias-Hernandez
- Respiratory Department, Medical Surgical Unit of Respiratory Diseases, Hospital Virgen del Rocio, Sevilla, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
| | - Remedios Otero-Candelera
- Respiratory Department, Medical Surgical Unit of Respiratory Diseases, Hospital Virgen del Rocio, Sevilla, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
| | - Luis Jara-Palomares
- Respiratory Department, Medical Surgical Unit of Respiratory Diseases, Hospital Virgen del Rocio, Sevilla, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
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Lopez-Ruz S, Barca-Hernando M, Marin-Romero S, Elias-Hernandez T, Otero-Candelera R, Jara-Palomares L. Low-molecular-weight heparin beyond 12 months in patients with cancer-associated thrombosis. Br J Cancer 2022; 127:2234-2240. [PMID: 36241715 PMCID: PMC9727131 DOI: 10.1038/s41416-022-02007-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Clinical guidelines indicate that in patients with cancer-associated thrombosis (CAT), anticoagulant treatment should be continued beyond 6 months as long as the cancer is active. We aimed to analyse the safety of low-molecular-weight heparin (LMWH) beyond 12 months in patients with CAT. METHODS We performed a post hoc analysis of consecutive CAT patients from October 2008 to December 2019. The primary outcome was the rate of clinically relevant bleeding (CRB), and we compared two periods (1-12 vs. 12-24 months). Hazard ratio (HR), competing risk analysis and sensitivity analyses were performed. RESULTS Of the 588 patients included, 30.1% (n = 177) received LMWH beyond 12 months. The rate of CRB in the first 12 months compared to the 12-24 month period was 3.2 per 100 patients/month (95% CI 2.5-4.1) vs. 0.9 per 100 patients/month (95% CI 0.4-1.5), (P < 0.0001). The competing risk analysis of CRB comparing both periods showed a lower sub-distribution hazard ratio (SHR) during the period 12-24 months (SHR: 0.5, 95% CI: 0.3-0.8, P < 0.001). CONCLUSION In patients with cancer-associated thrombosis under anticoagulant treatment with LMWH, the rate of clinically relevant bleeding and major bleeding were lower beyond 12 months.
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Affiliation(s)
- Sergio Lopez-Ruz
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Hospital Virgen del Rocío, Sevilla, 41013, España
| | - Maria Barca-Hernando
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Hospital Virgen del Rocío, Sevilla, 41013, España
| | - Samira Marin-Romero
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Hospital Virgen del Rocío, Sevilla, 41013, España
| | - Teresa Elias-Hernandez
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Hospital Virgen del Rocío, Sevilla, 41013, España
| | - Remedios Otero-Candelera
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Hospital Virgen del Rocío, Sevilla, 41013, España
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España
| | - Luis Jara-Palomares
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Hospital Virgen del Rocío, Sevilla, 41013, España.
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España.
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Barca-Hernando M, Muñoz-Martin AJ, Rios-Herranz E, Garcia-Escobar I, Beato C, Font C, Oncala-Sibajas E, Revuelta-Rodriguez A, Areses MC, Rivas-Jimenez V, Ballaz-Quincoces A, Moreno-Santos MA, Lopez-Saez JB, Gallego-Gallego I, Elias-Hernandez T, Asensio-Cruz MI, Chasco-Eguilaz L, Garcia-Gonzalez G, Estevez-Garcia P, Marin-Barrera L, Otero-Candelera R, Lopez-Ruz S, Lima-Alvarez J, Sanchez-Diaz JM, Real-Dominguez M, Borrego-Delgado MC, Marin-Romero S, Jara-Palomares L. Case-Control Analysis of the Impact of Anemia on Quality of Life in Patients with Cancer: A Qca Study Analysis. Cancers (Basel) 2021; 13:2517. [PMID: 34063886 PMCID: PMC8196564 DOI: 10.3390/cancers13112517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/03/2021] [Accepted: 05/16/2021] [Indexed: 01/22/2023] Open
Abstract
Anemia is a common condition in cancer patients and is associated with a wide variety of symptoms that impair quality of life (QoL). However, exactly how anemia affects QoL in cancer patients is unclear because of the inconsistencies in its definition in previous reports. We aimed to examine the clinical impact of anemia on the QoL of cancer patients using specific questionnaires. We performed a post-hoc analysis of a multicenter, prospective, case-control study. We included patients with cancer with (cases) or without (controls) anemia. Participants completed the European Organization for Research and Treatment of Cancer Quality of Life questionnaire version 3.0 (EORTC QLQ-C30) and Euro QoL 5-dimension 3-level (EQ-5D-3L) questionnaire. Statistically significant and clinically relevant differences in the global health status were examined. From 2015 to 2018, 365 patients were included (90 cases and 275 controls). We found minimally important differences in global health status according to the EORTC QLQ-C30 questionnaire (case vs. controls: 45.6 vs. 58%, respectively; mean difference: -12.4, p < 0.001). Regarding symptoms, cancer patients with anemia had more pronounced symptoms in six out of nine scales in comparison with those without anemia. In conclusion, cancer patients with anemia had a worse QoL both clinically and statistically.
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Affiliation(s)
- Maria Barca-Hernando
- Medical Surgical Unit of Respiratory Diseases, Respiratory Department, Hospital Virgen del Rocio, CIBERES, 41013 Sevilla, Spain; (M.B.-H.); (T.E.-H.); (M.I.A.-C.); (L.M.-B.); (R.O.-C.); (S.L.-R.); (M.C.B.-D.); (S.M.-R.)
| | - Andres J. Muñoz-Martin
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, 28009 Madrid, Spain; (A.J.M.-M.); (I.G.-G.); (G.G.-G.)
| | - Eduardo Rios-Herranz
- Hematology and Hemotherapy Department, Hospital Universitario Virgen de Valme, 41701 Sevilla, Spain;
| | - Ignacio Garcia-Escobar
- Medical Oncology Department, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain;
| | - Carmen Beato
- Medical Oncology Department, Hospital Virgen de la Macarena, 41009 Sevilla, Spain;
| | - Carme Font
- Medical Oncology Department, DIBAPS/Translational Genomics and Targeted Therapeutics in Solid Tumors, Hospital Clínic, 08036 Barcelona, Spain;
| | | | | | | | - Victor Rivas-Jimenez
- Medical Oncology Department, Hospital de Jerez de la Frontera, 11407 Cádiz, Spain;
| | - Aitor Ballaz-Quincoces
- Respiratory Department, Hospital de Galdakao-Usansolo, 48960 Bizkaia, Spain; (A.B.-Q.); (L.C.-E.)
| | | | | | - Iria Gallego-Gallego
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, 28009 Madrid, Spain; (A.J.M.-M.); (I.G.-G.); (G.G.-G.)
| | - Teresa Elias-Hernandez
- Medical Surgical Unit of Respiratory Diseases, Respiratory Department, Hospital Virgen del Rocio, CIBERES, 41013 Sevilla, Spain; (M.B.-H.); (T.E.-H.); (M.I.A.-C.); (L.M.-B.); (R.O.-C.); (S.L.-R.); (M.C.B.-D.); (S.M.-R.)
| | - Maria Isabel Asensio-Cruz
- Medical Surgical Unit of Respiratory Diseases, Respiratory Department, Hospital Virgen del Rocio, CIBERES, 41013 Sevilla, Spain; (M.B.-H.); (T.E.-H.); (M.I.A.-C.); (L.M.-B.); (R.O.-C.); (S.L.-R.); (M.C.B.-D.); (S.M.-R.)
| | - Leyre Chasco-Eguilaz
- Respiratory Department, Hospital de Galdakao-Usansolo, 48960 Bizkaia, Spain; (A.B.-Q.); (L.C.-E.)
| | - Gonzalo Garcia-Gonzalez
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, 28009 Madrid, Spain; (A.J.M.-M.); (I.G.-G.); (G.G.-G.)
| | | | - Lucia Marin-Barrera
- Medical Surgical Unit of Respiratory Diseases, Respiratory Department, Hospital Virgen del Rocio, CIBERES, 41013 Sevilla, Spain; (M.B.-H.); (T.E.-H.); (M.I.A.-C.); (L.M.-B.); (R.O.-C.); (S.L.-R.); (M.C.B.-D.); (S.M.-R.)
| | - Remedios Otero-Candelera
- Medical Surgical Unit of Respiratory Diseases, Respiratory Department, Hospital Virgen del Rocio, CIBERES, 41013 Sevilla, Spain; (M.B.-H.); (T.E.-H.); (M.I.A.-C.); (L.M.-B.); (R.O.-C.); (S.L.-R.); (M.C.B.-D.); (S.M.-R.)
| | - Sergio Lopez-Ruz
- Medical Surgical Unit of Respiratory Diseases, Respiratory Department, Hospital Virgen del Rocio, CIBERES, 41013 Sevilla, Spain; (M.B.-H.); (T.E.-H.); (M.I.A.-C.); (L.M.-B.); (R.O.-C.); (S.L.-R.); (M.C.B.-D.); (S.M.-R.)
| | - Jorge Lima-Alvarez
- Respiratory Department, Hospital Universitario Virgen de Valme, 41701 Sevilla, Spain;
| | - Jose Maria Sanchez-Diaz
- Medical Surgical Unit of Respiratory Diseases, Pharmacy, Respiratory Department, Hospital Virgen del Rocio, 41013 Sevilla, Spain;
| | - Macarena Real-Dominguez
- Department of Preventive Medicine and Public Health, Universidad de Málaga, 29071 Málaga, Spain;
| | - Maria Carmen Borrego-Delgado
- Medical Surgical Unit of Respiratory Diseases, Respiratory Department, Hospital Virgen del Rocio, CIBERES, 41013 Sevilla, Spain; (M.B.-H.); (T.E.-H.); (M.I.A.-C.); (L.M.-B.); (R.O.-C.); (S.L.-R.); (M.C.B.-D.); (S.M.-R.)
| | - Samira Marin-Romero
- Medical Surgical Unit of Respiratory Diseases, Respiratory Department, Hospital Virgen del Rocio, CIBERES, 41013 Sevilla, Spain; (M.B.-H.); (T.E.-H.); (M.I.A.-C.); (L.M.-B.); (R.O.-C.); (S.L.-R.); (M.C.B.-D.); (S.M.-R.)
| | - Luis Jara-Palomares
- Medical Surgical Unit of Respiratory Diseases, Respiratory Department, Hospital Virgen del Rocio, CIBERES, 41013 Sevilla, Spain; (M.B.-H.); (T.E.-H.); (M.I.A.-C.); (L.M.-B.); (R.O.-C.); (S.L.-R.); (M.C.B.-D.); (S.M.-R.)
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Jara-Palomares L, Marin-Romero S, Asensio-Cruz MI, Elias-Hernandez T, Otero-Candelera R. Intermittent pneumatic compression plus pharmacological thromboprophylaxis to prevent deep vein thrombosis. J Thorac Dis 2019; 11:1731-1733. [PMID: 31285860 DOI: 10.21037/jtd.2019.05.38] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Luis Jara-Palomares
- Medical Surgical Unit of Respiratory Diseases, Virgen del Rocio Hospital, Seville, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Samira Marin-Romero
- Medical Surgical Unit of Respiratory Diseases, Virgen del Rocio Hospital, Seville, Spain
| | - María Isabel Asensio-Cruz
- Medical Surgical Unit of Respiratory Diseases, Virgen del Rocio Hospital, Seville, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Teresa Elias-Hernandez
- Medical Surgical Unit of Respiratory Diseases, Virgen del Rocio Hospital, Seville, Spain
| | - Remedios Otero-Candelera
- Medical Surgical Unit of Respiratory Diseases, Virgen del Rocio Hospital, Seville, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
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Jara-Palomares L, Solier-Lopez A, Elias-Hernandez T, Asensio-Cruz MI, Blasco-Esquivias I, Sanchez-Lopez V, de la Borbolla MR, Arellano-Orden E, Suarez-Valdivia L, Marin-Romero S, Marin-Barrera L, Ruiz-Garcia A, Montero-Romero E, Navarro-Herrero S, Lopez-Campos JL, Serrano-Gotarredona MP, Praena-Fernandez JM, Sanchez-Diaz JM, Otero-Candelera R. D-dimer and high-sensitivity C-reactive protein levels to predict venous thromboembolism recurrence after discontinuation of anticoagulation for cancer-associated thrombosis. Br J Cancer 2018; 119:915-921. [PMID: 30318508 PMCID: PMC6203717 DOI: 10.1038/s41416-018-0269-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 08/27/2018] [Accepted: 08/31/2018] [Indexed: 11/29/2022] Open
Abstract
Background Optimal duration of anticoagulation for cancer-associated thrombosis (CAT) remains unclear. This study assessed D-dimer (DD) and high-sensitivity C-reactive protein (hs-CRP) levels after the withdrawal of anticoagulation treatment to predict the risk of venous thromboembolism (VTE) recurrence among patients with CAT. Methods Prospective, multicentre study to evaluate CAT with ≥3 months of anticoagulation that was subsequently discontinued. Blood samples were taken when patients stopped the anticoagulation and 21 days later to determine the DD and hs-CRP levels. All patients were followed up for 6 months to detect VTE recurrence. Results Between 2013 and 2015, 325 patients were evaluated and 114 patients were ultimately enrolled in the study. The mean age was 62 ± 14 years and nearly 40% had metastasis. Ten patients developed VTE recurrence within 6 months (8.8%, 95% confidence interval [CI]: 4.3–15.5%). The DD and hs-CRP levels after 21 days were associated with VTE recurrence. The subdistribution hazard ratios were 9.82 for hs-CRP (95% CI: 19–52) and 5.81 for DD (95% CI: 1.1–31.7). Conclusions This study identified that hs-CRP and DD were potential biomarkers of VTE recurrence after discontinuation of anticoagulation in CAT. A risk-adapted strategy could identify low-risk patients who may benefit from discontinuation of anticoagulation.
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Affiliation(s)
- Luis Jara-Palomares
- Medical Surgical Unit of Respiratory Diseases, Virgen del Rocio Hospital, Seville, Spain. .,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.
| | - Aurora Solier-Lopez
- Medical Surgical Unit of Respiratory Diseases, Virgen del Rocio Hospital, Seville, Spain
| | - Teresa Elias-Hernandez
- Medical Surgical Unit of Respiratory Diseases, Virgen del Rocio Hospital, Seville, Spain
| | | | | | | | | | - Elena Arellano-Orden
- Institute of Biomedicine of Seville (IBIS), Virgen del Rocío Hospital, Seville, Spain
| | - Lionel Suarez-Valdivia
- Medical Surgical Unit of Respiratory Diseases, Virgen del Rocio Hospital, Seville, Spain
| | - Samira Marin-Romero
- Medical Surgical Unit of Respiratory Diseases, Virgen del Rocio Hospital, Seville, Spain
| | - Lucia Marin-Barrera
- Medical Surgical Unit of Respiratory Diseases, Virgen del Rocio Hospital, Seville, Spain
| | | | | | | | - Jose Luis Lopez-Campos
- Medical Surgical Unit of Respiratory Diseases, Virgen del Rocio Hospital, Seville, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
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Jara-Palomares L, Elias-Hernandez T, Asensio-Cruz MI, Marin-Romero S, Otero-Candelera R. Towards a precision medicine in venous thromboembolism associated to lung cancer. J Thorac Dis 2018; 10:S3064-S3066. [PMID: 30370080 PMCID: PMC6186635 DOI: 10.21037/jtd.2018.08.40] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 08/06/2018] [Indexed: 12/26/2022]
Affiliation(s)
- Luis Jara-Palomares
- Medical Surgical Unit of Respiratory Diseases, Virgen del Rocio Hospital, Seville, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Teresa Elias-Hernandez
- Medical Surgical Unit of Respiratory Diseases, Virgen del Rocio Hospital, Seville, Spain
| | | | - Samira Marin-Romero
- Medical Surgical Unit of Respiratory Diseases, Virgen del Rocio Hospital, Seville, Spain
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Jara-Palomares L, Solier-Lopez A, Elias-Hernandez T, Asensio-Cruz M, Blasco-Esquivias I, Marin-Barrera L, de la Borbolla-Artacho MR, Praena-Fernandez JM, Montero-Romero E, Navarro-Herrero S, Serrano-Gotarredona MP, Sánchez-Díaz JM, Palacios C, Otero R. Tinzaparin in cancer associated thrombosis beyond 6 months: TiCAT study. Thromb Res 2017; 157:90-96. [DOI: 10.1016/j.thromres.2017.07.004] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Revised: 06/25/2017] [Accepted: 07/03/2017] [Indexed: 01/06/2023]
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Jara-Palomares L, Otero R, Jimenez D, Praena-Fernandez JM, Elias-Hernandez T, Monreal M. Response. Chest 2017; 151:728-729. [PMID: 28279282 DOI: 10.1016/j.chest.2016.11.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 11/23/2016] [Indexed: 12/01/2022] Open
Affiliation(s)
- Luis Jara-Palomares
- Medical Surgical Unit of Respiratory Diseases, Virgen del Rocio Hospital, Seville, Spain; Instituto de Biomedicina de Sevilla, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Seville, Spain.
| | - Remedios Otero
- Medical Surgical Unit of Respiratory Diseases, Virgen del Rocio Hospital, Seville, Spain; Instituto de Biomedicina de Sevilla, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Seville, Spain
| | - David Jimenez
- Respiratory Department, Ramón y Cajal Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Juan Manuel Praena-Fernandez
- Statistics, Methodology and Research Evaluation Unit, Andalusian Public Foundation for Health Research Management, Hospital Virgen del Rocío, Seville, Spain
| | - Teresa Elias-Hernandez
- Medical Surgical Unit of Respiratory Diseases, Virgen del Rocio Hospital, Seville, Spain; Instituto de Biomedicina de Sevilla, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Seville, Spain
| | - Manuel Monreal
- Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol de Badalona, Barcelona, Universidad Católica de Murcia, Spain
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Jara-Palomares L, Sanchez-Oro-Gomez R, Elias-Hernandez T, Morillo-Guerrero R, Ferrer-Galvan M, Asensio-Cruz MI, Barrot-Cortes E, Otero-Candelera R. Corrigendum to ‘Rivaroxaban for the treatment of venous thromboembolism. A “real-life” perspective in 103 patients’ [Thrombosis Research 134 (2014) 617–621]. Thromb Res 2015. [DOI: 10.1016/j.thromres.2015.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Jara-Palomares L, Sanchez-Oro-Gomez R, Elias-Hernandez T, Morillo-Guerrero R, Ferrer-Galvan M, Asensio-Cruz MI, Barrot-Cortes E, Otero-Candelera R. Rivaroxaban for the treatment of venous thromboembolism. A "real-life" perspective in 103 patients. Thromb Res 2014; 134:617-21. [PMID: 25034320 DOI: 10.1016/j.thromres.2014.06.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 06/13/2014] [Accepted: 06/27/2014] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Randomized clinical trials have demonstrated non-inferiority of rivaroxaban compared with vitamin K antagonists (VKAs) in the treatment of venous thromboembolism (VTE). Our objective was to analyze in real life, tolerance, recurrence, bleeding and adverse events of rivaroxaban in patients with acute symptomatic VTE. MATERIAL AND METHODS Open follow-up study of a cohort of patients aged 18 and over diagnosed with deep vein thrombosis (DVT) and/or pulmonary embolism (PE) treated with rivaroxaban from December 2011 to January 2014. RESULTS The total number of patients treated with rivaroxaban was 103. The mean age was 58+/-17 years. The most frequent co-morbidities were: hypertension (30.0%), dyslipidemia (23.3%) and respiratory disease (25.2%). The type of thromboembolic event treated was: DVT (64.1%), PE (18.4%), DVT+PE (17.5%). Of the rivaroxaban-treated patients, 30% did so from the initial anticoagulant therapy and the other 70% in long-term or extended anticoagulant therapy. The median time of treatment with rivaroxaban was 6 months [corrected]. There was one recurrence and no deaths occurred. Six patients had bleeding, one of which was severe. CONCLUSIONS Rivaroxaban provides a therapeutic alternative in a group of patients with VTE with advantages over VKAs, because of the convenience in dosing, lack of requirements for periodic monitoring and limited interaction with other drugs.
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Affiliation(s)
- Luis Jara-Palomares
- Medical Surgical Unit of Respiratory Diseases, Hospital Virgen del Rocío, CIBERES, Seville, Spain
| | - Raquel Sanchez-Oro-Gomez
- Medical Surgical Unit of Respiratory Diseases, Hospital Virgen del Rocío, CIBERES, Seville, Spain
| | - Teresa Elias-Hernandez
- Medical Surgical Unit of Respiratory Diseases, Hospital Virgen del Rocío, CIBERES, Seville, Spain
| | - Raquel Morillo-Guerrero
- Medical Surgical Unit of Respiratory Diseases, Hospital Virgen del Rocío, CIBERES, Seville, Spain
| | - Marta Ferrer-Galvan
- Medical Surgical Unit of Respiratory Diseases, Hospital Virgen del Rocío, CIBERES, Seville, Spain
| | | | - Emilia Barrot-Cortes
- Medical Surgical Unit of Respiratory Diseases, Hospital Virgen del Rocío, CIBERES, Seville, Spain
| | - Remedios Otero-Candelera
- Medical Surgical Unit of Respiratory Diseases, Hospital Virgen del Rocío, CIBERES, Seville, Spain
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Jara-Palomares L, Otero-Candelera R, Elias-Hernandez T, Cayuela-Dominguez A, Ferrer-Galvan M, Alfaro MJ, Montero E, Barrot-Cortes E. Dyslipidemia as a long-term marker for survival in pulmonary embolism. Rev Port Pneumol 2011; 17:205-10. [PMID: 21549676 DOI: 10.1016/j.rppneu.2011.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2010] [Accepted: 03/10/2011] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES To analyse survival rate after 24 months in consecutive patients with a diagnosis of PE as well as associated factors. METHODS Prospective cohort study during a follow-up period of two years in a series of consecutive patients with PE. RESULTS During the follow-up period, 34 out of 148 patients died (23%). Factors independently associated with reduced survival rate were: creatinine levels > 2 (OR, 8.8; 95% CI, 1.1 - 70.87), previous neoplasm (OR, 8.8; 95% CI, 3.69 - 20.98), dementia (OR, 6.85; 95% CI, 2.1 - 22.33) and dyslipidemia (OR, 5.07; 95% CI, 1.92 - 13.44). Forty four percent of the patients with dyslipidemia died vs. 20.8% of patients without this condition. CONCLUSIONS In our study dyslipidemia shows as a long-term negative prognostic marker for survival in patients with EP.
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Affiliation(s)
- L Jara-Palomares
- Medical-Surgical Unit of Respiratory Diseases, University Hospital Virgen del Rocio, Seville, Spain.
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