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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Medicine+(Baltimore)
2016 ; 95
(34
): e4364
Nephropedia Template TP
gab.com Text
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English Wikipedia
Five-year follow-up of pulmonary embolism under anticoaugulation: The PISA-PEET
(Pulmonary Embolism Extension Therapy) study
#MMPMID27559946
Marconi L
; Carrozzi L
; Aquilini F
; Celi A
; Pistelli F
; Palla A
Medicine (Baltimore)
2016[Aug]; 95
(34
): e4364
PMID27559946
show ga
Benefits and harms of long-term anticoagulant therapy (AT) after acute pulmonary
embolism (PE) are poorly known. The aim of this study was to investigate the
outcome of patients with PE treated with AT for 5 years according to American
College of Chest Physicians (ACCP) guidelines.Patients with both unprovoked and
secondary PE were consecutively enrolled in a "real life" study. After a 12-month
AT, they continued or stopped the treatment according to ACCP guidelines, and
were followed-up for 5 years. Outcomes were all-cause mortality, recurrence, and
fatal recurrence under AT.Of the original consecutive 585 patients, 471 were
included (83 dead, 31 lost during the 1st year). Of these, 361 (76.6%) continued
AT. During 5 years, death occurred in 109 (30.2%) patients, with a mortality rate
of 8.00?events/100 person-years of follow-up; recurrence in 34 (9.4%), with an
incidence rate of 2.58?events/person-years; fatal recurrence in 13 (3.6%), with
an incidence rate of 0.95?events/person-years. The case fatality rate for
recurrence was 38.2%. In the subgroup of patients with unprovoked PE, the chance
of dying was significantly lower (RR 0.35; 95% confidence interval 0.24-0.53) and
the tendency to fatal recurrence (not significantly) greater (0.11?events/100
person-years vs 0.07?events/100 person-years) than in the remaining patients.
Major bleeding occurred in 5 (1.3%) patients. The case fatality rate for bleeding
was 14.3%.During 5-year AT, 30% of patients dies, 10% experiences recurrences,
and 5% has fatal recurrences. According to guidelines, most patients need to
continue AT; the case fatality rate for bleeding is lower than that for
recurrence.
|Aged
[MESH]
|Aged, 80 and over
[MESH]
|Anticoagulants/adverse effects/*therapeutic use
[MESH]
|Cause of Death
[MESH]
|Female
[MESH]
|Follow-Up Studies
[MESH]
|Hemorrhage/*chemically induced/*mortality
[MESH]
|Heparin, Low-Molecular-Weight/therapeutic use
[MESH]