Prevalence of Hereditary Thrombophilia in Patients Older Than 75 Years With Venous Thromboembolism Referred for Thrombophilia Screening

Siguret, Virginie; Emmerich, Joseph; Belleville, Tiphaine; Mazoyer, E.; Gouin‐Thibault, Isabelle; Pautas, Éric

doi:10.1093/gerona/glu240

Cited by 5 publications

(5 citation statements)

References 20 publications

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“…According to our findings, the incidence of UPE in older adults with PE is lower than the incidence of UPE in adults with PE -14.5% in older adults with PE compared with up to 50% in adults with PE [1,7] -but it is not rare in older adults. Of note, the incidence of UPE in older adults with PE may be even lower; our findings may be an overestimation of the true incidence of UPE in older adults with PE, since only a few of the UPE patients in our study have undergone a genetic thrombophilia workup, and since according to Siguret et al [9], 14.4% of older adults with venous thromboembolism have at least one inherited thrombophilia. The low incidence of UPE in older adults with PE may be explained by the high prevalence of malignancies, immobility, surgery, and osteoporotic fractures in this population.…”

Section: Discussioncontrasting

confidence: 52%

Unprovoked pulmonary embolism in older adults: incidence and prognosis

et al. 2021

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IntroductionUnprovoked pulmonary embolism (UPE) is not rare and it is associated with an unfavorable prognosis in adults. However, the incidence and the prognosis of UPE in older adults have never been studied.Material and methodsThis was a historical prospective study. We reviewed all the medical charts of all older adults (aged 70 years or more) with UPE, provoked pulmonary embolism (PPE), and malignancy-associated PE (MAPE), admitted to a tertiary medical center between 2010 and 2012. The all-cause 3-year mortality rates and cumulative survival following admission were compared between the groups.ResultsThe final cohort included 249 patients with PE: 161 (64.7%) were women; the mean age was 79.8 ±5.7 years. Overall, 36 (14.5%) patients had UPE, 81 (32.5%) patients had MAPE, and 132 (53.0%) patients had PPE. Overall, 39 (15.7%) patients died within 30 days, 76 (30.5%) patients died within 6 months, 101 (40.6%) patients died within 1 year, and 136 (54.6%) patients died within 3 years of admission. Relative to PPE and MAPE patients, the cumulative survival was significantly higher in UPE patients at each time point within 1 year of admission (p < 0.05 and p < 0.001, respectively). However, 3 years after admission, the cumulative survival was comparable between PPE patients and UPE patients, and was significantly lower in MAPE patients (p < 0.001).ConclusionsUPE is not rare in older adults with PE, and it is associated with a favorable prognosis within 1 year of admission in this population.

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Section: Discussioncontrasting

confidence: 52%

Unprovoked pulmonary embolism in older adults: incidence and prognosis

et al. 2021

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“…People with prothrombin 13 13 thrombophilia are more likely to develop a clot if they also have another clotting disorder such as factor V Leiden thrombophilia, protein S deficiency, or hyperhomocysteinemia [124][125][126]. In addition, combined oral contraceptives, oral hormone replacement therapy and thrombophilias are recognized risk factors for venous thromboembolism in women [127,128].…”

Section: Hormonal Changesmentioning

confidence: 99%

Primary and secondary haemostasis changes related to aging

Sepúlveda

Palomo

Fuentes

2015

Mechanisms of Ageing and Development

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“…In addition, the measurement of D-dimer levels, which may help identify patients requiring an extended anticoagulation [ 4 , 6 ], is unlikely to predict the risk of recurrence in elderly patients, probably as it is commonly altered in this population [ 7 ]. Finally, the presence of inherited thrombophilic alterations was shown to be relatively frequent in elderly people with VTE, but not associated with the risk of VTE recurrence [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Design and rationale of a randomized, placebo-controlled trial on the efficacy and safety of sulodexide for extended treatment in elderly patients after a first venous thromboembolism

Palareti¹,

Legnani²,

Antonucci³

et al. 2020

Intern Emerg Med

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How to prevent recurrences after a first venous thromboembolic (VTE) event in elderly patients is still an open issue, especially because of the high bleeding risk of anticoagulation in these patients. The placebo-controlled “Jason” study aims at assessing the efficacy and safety for secondary VTE prevention in elderly patients of oral Sulodexide (Vessel®) administration, a mixture of glycosaminoglycans (Alfasigma, Bologna, Italy) which proved effective against recurrences in a general population (SURVET study) without major bleeding (MB) complications. 1450 patients, aged ≥ 75 years, after at least 3 months of anticoagulation treatment for a first VTE episode, are double-blind randomized to receive for 12 months either sulodexide 500 lipasemic units (LSUs) twice daily, or sulodexide 250 LSU twice daily + indistinguishable placebo, or indistinguishable placebo. Primary outcomes for efficacy are the composite of death for VTE and recurrent VTE, and occurrence of MB for safety. Secondary outcomes include stroke, cardiovascular death and other thromboembolic events, and MB + clinically relevant non-MB. The first patient is scheduled to be randomized in May 2020. The study protocol has been approved by AIFA (Agenzia Italiana del Farmaco) and the Ethics Committee of the coordinating center. Written informed consent will be obtained from all patients prior to study participation. Jason study is an investigator-initiated trial, promoted by “Arianna Anticoagulazione” Foundation, Bologna, Italy, and supported by Alfasigma, Bologna, Italy. Study findings will be disseminated to participant centers, at research conferences and in peer-reviewed journals. Trial registration numbers NCT 04257487; EudraCT (2019–000570-33).

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Prevalence of Hereditary Thrombophilia in Patients Older Than 75 Years With Venous Thromboembolism Referred for Thrombophilia Screening

Abstract: Our study provides new data on genetic risk factors for VTE in the very elderly people. Whether identification of hereditary thrombophilia in elderly patients may influence patient's management in this age group remains unanswered.

Cited by 5 publications

References 20 publications

Unprovoked pulmonary embolism in older adults: incidence and prognosis

Unprovoked pulmonary embolism in older adults: incidence and prognosis

Primary and secondary haemostasis changes related to aging

Design and rationale of a randomized, placebo-controlled trial on the efficacy and safety of sulodexide for extended treatment in elderly patients after a first venous thromboembolism

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