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意大利静脉血栓栓塞症患者的管理:来自VTE注册研究PREFER的见解

The management of patients with venous thromboembolism in Italy: insights from the PREFER in VTE registry.

作者信息

Guercini Francesco, Mommi Valeria, Camporese Giuseppe, Tonello Chiara, Imberti Davide, Benedetti Raffaella, De Bartolomeo Giuseppe, Di Lecce Livio, Romeo Fabio, Agnelli Giancarlo

机构信息

Internal Cardiovascular and Emergency Medicine, Stroke Unit, University of Perugia, 06126, Perugia, Italy.

Unit of Angiology at the Department of Cardiac, Thoracic and Vascular Sciences, University Hospital of Padua, Padua, Italy.

出版信息

Intern Emerg Med. 2016 Dec;11(8):1095-1102. doi: 10.1007/s11739-016-1507-6. Epub 2016 Jul 22.

Abstract

Venous thromboembolism (VTE) is the third most common cardiovascular disease. Real-life data on the clinical presentation, risk factors, diagnosis, and treatment of VTE in Italy and Europe are required to optimize the management of this disease. The PREFER in VTE registry, a prospective non-interventional real-life study, was designed to assess clinical characteristics and management of patients with VTE, use of health care resources, and on-treatment patient quality of life. Eligible consecutive patients with objectively diagnosed VTE were enrolled in the registry and followed up for 12 months. Between January and December 2013, 816 Italian and 1027 patients from 6 European countries other than Italy (European patients) were enrolled in the registry, and followed up until December 2014. Italian patients were the oldest (mean age 65.7 years) among the European patients. The Italian patients with a history of cancer were 24.6 % of whom 63.2 % had an active cancer (18.2 and 57.0 %, respectively, in Europe). Parenteral heparin was given, as initial treatment, in 73.8 % of Italian patients (66.4 % in Europe); VKA in combination with other treatments in 45.8 % (34.7 % in Europe); and VKA as the only anticoagulant treatment in 24.4 % (17.2 % in Europe). Of the Italian patients, 43.2 and 90.6 % of patients were hospitalized for deep vein thrombosis and pulmonary embolism, respectively; 65.4 % were admitted to the hospital through the emergency department. Following a real world approach, PREFER in VTE shows that the Italian patients, among and compared to the European patients, are the oldest, have a history of cancer more commonly, receive an initial treatment with heparin more commonly, and are more commonly hospitalized, particularly if affected by PE.

摘要

静脉血栓栓塞症(VTE)是第三常见的心血管疾病。需要意大利和欧洲关于VTE临床表现、危险因素、诊断和治疗的真实数据,以优化该疾病的管理。VTE中的PREFER注册研究是一项前瞻性非干预性真实研究,旨在评估VTE患者的临床特征和管理、医疗资源的使用以及治疗期间患者的生活质量。符合条件的客观诊断为VTE的连续患者被纳入注册研究并随访12个月。在2013年1月至12月期间,816名意大利患者和来自意大利以外6个欧洲国家的1027名患者(欧洲患者)被纳入注册研究,并随访至2014年12月。意大利患者是欧洲患者中年龄最大的(平均年龄65.7岁)。有癌症病史的意大利患者占24.6%,其中63.2%患有活动性癌症(在欧洲分别为18.2%和57.0%)。作为初始治疗,73.8%的意大利患者接受了胃肠外肝素治疗(欧洲为66.4%);45.8%的患者接受了维生素K拮抗剂(VKA)联合其他治疗(欧洲为34.7%);24.4%的患者仅接受VKA作为抗凝治疗(欧洲为17.2%)。意大利患者中,分别有43.2%和90.6%的患者因深静脉血栓形成和肺栓塞住院;65.4%的患者通过急诊科入院。采用真实世界的方法,VTE中的PREFER研究表明,在欧洲患者中以及与欧洲患者相比,意大利患者年龄最大,更常见有癌症病史,更常见接受肝素初始治疗,并且更常住院,尤其是在患有肺栓塞的情况下。

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