FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W4294578296> ?p ?o ?g. }

• W4294578296 endingPage "322" @default.
• W4294578296 startingPage "320" @default.
• W4294578296 abstract "Free AccessQuality of warfarin anticoagulation in adults with short bowel syndrome on home parenteral nutritionRiccardo M. Fumagalli, Umberto Aimasso, Emanuele Valeriani, Nicola Mumoli, Marta Szlaszynska, Emilia Antonucci, Gualtiero Palareti, Daniela Mastroiacovo, Marcello Di Nisio, and Stefano BarcoRiccardo M. FumagalliRiccardo Mario Fumagalli, MD, UniversitätsSpital Zürich, Rämistrasse 100, 8091 Zurich, Switzerlandriccardomfumagalli@gmail.comhttps://orcid.org/0000-0002-6794-1986 Department of Angiology, University Hospital Zurich, Switzerland Search for more papers by this author, Umberto Aimasso Unit of Dietetics and Clinical Nutrition, Città della Salute e della Scienza, Torino, Italy Search for more papers by this author, Emanuele Valerianihttps://orcid.org/0000-0001-9729-3214 Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy Search for more papers by this author, Nicola Mumoli Department of Internal Medicine, Magenta Hospital, Magenta, Italy Department of Internal Medicine, Livorno Hospital, Livorno, Italy Search for more papers by this author, Marta Szlaszynskahttps://orcid.org/0000-0002-5919-9486 Department of Angiology, University Hospital Zurich, Switzerland Search for more papers by this author, Emilia Antonuccihttps://orcid.org/0000-0001-9185-2046 Arianna Anticoagulazione Foundation, Bologna, Italy Search for more papers by this author, Gualtiero Palaretihttps://orcid.org/0000-0002-4327-9561 Arianna Anticoagulazione Foundation, Bologna, Italy Search for more papers by this author, Daniela Mastroiacovo Angiology Unit, SS Filippo and Nicola Hospital, Avezzano (AQ), Italy Search for more papers by this author, Marcello Di Nisiohttps://orcid.org/0000-0001-5930-7304 Department of Medicine and Ageing Sciences, “G. D’Annunzio” University, Chieti, Italy Search for more papers by this author, and Stefano Barco Department of Angiology, University Hospital Zurich, Switzerland Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany Search for more papers by this authorPublished Online:September 05, 2022https://doi.org/10.1024/0301-1526/a001018PDF ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinkedInReddit SectionsMoreThe prevalence of home parenteral nutrition (HPN) in Europe is 0.65–12.7/1,000,000 adult population [1]. The risk of thromboembolic complications among HPN patients is high with an estimated annualized incidence of approximately 11.4% [2]. Risk factors for thromboembolic events include permanent venous catheters, hyperosmolar nutrition solutions, endothelial damage, and pre-existing prothrombotic diseases.The prevalent use of long-term anticoagulation among HPN patients ranges between 22% and 66% [3]. Currently, there is no firm evidence on optimal anticoagulation for HPN patients and prescriptions necessarily rely on individual characteristics. Extended parenteral anticoagulation may be associated with poor compliance, risk of heparin-induced thrombocytopenia (HIT), and osteoporosis. Direct oral anticoagulants seem to be a feasible option for the primary and secondary thrombosis prevention, although their bioavailability may vary depending on the degree of their oral absorption [4, 5, 6]. Finally, the quality of vitamin K antagonists (VKA) treatment is influenced by oral absorption, hepatic impairment associated with abnormal INR values, routine vitamin K supplementation, and bacterial overgrowth leading to impaired vitamin K metabolism. Despite this, VKA remains the most widely used drug class in this population and is recommended by the European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines in case of catheter-related venous thrombosis [7, 8].In light of the substantial paucity of data on the quality of VKA anticoagulation in adults on HPN, we studied this in patients on HPN and matched controls with an indication for VKA.We retrospectively analyzed a cohort of 12 consecutive patients on HPN and warfarin who have been followed for more than 3 months during follow-up. All patients were managed at the reference HPN center of the University Hospital in Torino, Italy (2004–2015). Patient data were retrieved from their medical records. HPN patients were matched based on sex, age, and the indication for anticoagulation in a 1:8 ratio to 96 patients on VKA enrolled in the Italian START register [9]. The quality of VKA was measured as time in therapeutic range (TTR; INR range: 2–3) calculated according to the interpolated Rosendaal′s formula and expressed as percentual of in-rage days.Baseline characteristics were analyzed using appropriate descriptive statistics. Thromboembolic complications (i.e., arterial and venous thromboembolism) and major bleeding events (International Society on Thrombosis and Haemostasis criteria) were recorded as reported by the treating medical staff and expressed as absolute number and incidence (number of events/100 patient-years). The time unit of statistical analysis was patient-year and the start of observation was set at onset of the VKA therapy. Individuals were right-censored at the time of event, VKA discontinuation, death or if they were lost to follow-up. Individuals still receiving VKA at the time of data collection were right-censored in accordance with the latest available follow-up visit. The software Jamovi (version 1.6) based on R language was used for the analysis. Ethical approval was obtained at each center participating in the START-registry and at the aforementioned HPN referral center.The baseline characteristics of the study population are depicted in Table I. The median follow-up time was 48 (Q1–Q3: 23–89) months for HPN patients and 30 (Q1–Q3: 19–43) months for controls. The most frequently used central vein catheter in HPN patients was the Groshong catheter (n=8). Median TTR calculated over the entire follow-up period was 62% (Q1–Q3: 47–73) in HPN patients and 68% (Q1–Q3: 55–78) in controls. During stable anticoagulation, namely excluding the initial 3 months of VKA therapy, TTR was 63% (Q1–Q3: 46–77) and 69% (Q1–Q3: 55-78), respectively. The incidence of a composite of thromboembolic, major bleeding, and anticoagulation-related death events was similar in both groups with an incidence ratio of 0.9 (95% CI: 0.2–3.0). A total of two bleeding and one thromboembolic complications was reported in HPN patients: one patient had a gastrointestinal bleeding and a second had a gastrointestinal bleeding and a catheter-related thrombosis. The latter had a low median TTR of 44.5%. Among controls there were 11 bleedings (6 gastrointestinal, 2 hematuria, 1 cranial and 2 unknown), 1 arterial thromboembolism (transient ischemic attack), and 1 anticoagulation-related death (fatal intracerebral hemorrhage).Table I Baseline characteristics and clinical outcomesPatients on HPNPatients not on HPNN=12N=96Notes. BMI: body-mass index; VKA: vitamin K antagonist; TTR: time in therapeutic range. The incidence rate is provided as number of events per 100 person-years (95% CI).Age (median±IQR)70±772±9Women (%)50%42%BMI (median±IQR) 23±527±5Active cancer, n (%)05 (6%)Inflammatory bowel disease (Crohn disease), n (%)2 (17%)0Autoimmune diseases, n. (%)06 (7%)Chronic kidney disease, n. (%)4 (33%)8 (9%)Hepatic dysfunction, n. (%)1 (8%)0Diabetes, n. (%)1 (8%)9 (10%)Heart failure, n. (%)2 (17%)6 (7%)Prior acute coronary syndrome, n. (%)2 (17%)15 (17%)Prior ischemic stroke or systemic embolism, n. (%)04 (6%)Prior major bleeding, n. (%)2 (18%)2 (2%)Therapy Short bowel syndrome, n. (%)100%0 Cause of resection Intestinal ischemia, n. (%) 7 (58%)– Peritonitis, n. (%)5 (42%)– Nutrition associated liver disease, n. (%)2 (17%)– Indication for VKA anticoagulation Venous thromboembolism, n. (%)7 (58%)58 (60%) Atrial fibrillation, n. (%)5 (42%)38 (40%) Months of follow up, median (25th–75th percentiles)48 (23–89)30 (19–43)Outcomes Overall TTR, median (25th–75th percentiles)62% (47–73)68% (55–78) Total events, n.313 Total events, incidence5.1 (1.0–14.9)5.5 (2.9–9.4) Arterial thromboembolism, incidence rate00.4 (0.005–2.2) Venous thromboembolism, incidence rate2.0 (0.03–11.1)0 Bleeding, incidence rate3.4 (0.4–12.3)5.1 (2.6–8.8) Anticoagulation related death, incidence rate00.4 (0.005–2.3)Table I Baseline characteristics and clinical outcomesView as image HTML Our findings indicate that the quality of VKA anticoagulation in HPN patients appeared similar to that observed in controls (62% vs. 68%), and exceeding the 60% limit from the literature defining adequate anticoagulation [10]. This group of HPN patients seemed to be characterized by similar rate of anticoagulant-related complications than controls and by an overall lower event rates as compared to other HPN cohorts of unselected patients [2, 7]. This study has a number of limitations which include the small sample size and consequently the low precision of the estimates, the retrospective study design, unaccounted differences in the baseline characteristics between groups, and the lack of information concerning HPN cases in whom VKA was discontinued early (i.e., in the first 3 months) possibly due to poor INR control. Moreover, one cannot exclude that the good quality of VKA treatment among HPN patients may have been due, at least in part, to higher intensity of medical care.In conclusion, we provided initial data on the quality of VKA in selected adult patients on HPN, suggesting that VKA might be adequately managed also in this patient population and associated to an acceptable rate of complications.References1 Bakker H, Bozzetti F, Staun M, Leon-Sanz M, Hebuterne X, Pertkiewicz M, et al. Home parenteral nutrition in adults: a european multicentre survey in 1997. ESPEN-Home Artificial Nutrition Working Group. Clin Nutr. 1999;18(3):135–40. First citation in articleCrossref Medline, Google Scholar2 Barco S, Heuschen CB, Salman B, Brekelmans MP, Serlie MJ, Middeldorp S, et al. Home parenteral nutrition-associated thromboembolic and bleeding events: results of a cohort study of 236 individuals. J Thromb Haemost. 2016;14(7):1364–73. First citation in articleCrossref Medline, Google Scholar3 Barco S, Atema JJ, Coppens M, Serlie MJ, Middeldorp S. Anticoagulants for the prevention and treatment of catheter-related thrombosis in adults and children on parenteral nutrition: a systematic review and critical appraisal. Blood Transfus. 2017;15(4):369–77. First citation in articleMedline, Google Scholar4 Christensen LD, Vinter-Jensen L, Rasmussen HH, Kristensen SR, Larsen TB. Rivaroxaban as anticoagulant therapy in short bowel syndrome. Report of three cases. Thromb Res. 2015;135(3):568–70. First citation in articleCrossref Medline, Google Scholar5 Cheung YW, Barco S, Mathot RAA, van den Dool EJ, Stroobants AK, Serlie MJ, et al. Pharmacokinetics of dabigatran etexilate and rivaroxaban in patients with short bowel syndrome requiring parenteral nutrition: The PDER PAN study. Thromb Res. 2017;160:76–82. First citation in articleCrossref Medline, Google Scholar6 Douros A, Schlemm L, Bolbrinker J, Ebinger M, Kreutz R. Insufficient anticoagulation with dabigatran in a patient with short bowel syndrome. Thromb Haemost. 2014;112(2):419–20. First citation in articleMedline, Google Scholar7 Gillis V, van Houdt T, Wouters Y, Wanten GJA. Anticoagulants decrease the risk for catheter-related venous thrombosis in patients with chronic intestinal failure: A long-term cohort study. J Parenter Enteral Nutr. 2021. First citation in articleMedline, Google Scholar8 Cuerda C, Pironi L, Arends J, Bozzetti F, Gillanders L, Jeppesen PB, et al. ESPEN practical guideline: Clinical nutrition in chronic intestinal failure. Clin Nutr. 2021;40(9):5196–220. First citation in articleCrossref Medline, Google Scholar9 Antonucci E, Poli D, Tosetto A, Pengo V, Tripodi A, Magrini N, et al. The Italian START-Register on Anticoagulation with Focus on Atrial Fibrillation. PLoS One. 2015;10(5):e0124719. First citation in articleCrossref Medline, Google Scholar10 Erkens PM, ten Cate H, Buller HR, Prins MH. Benchmark for time in therapeutic range in venous thromboembolism: a systematic review and meta-analysis. PLoS One. 2012;7(9):e42269. First citation in articleCrossref Medline, Google ScholarFiguresReferencesRelatedDetails Volume 51Issue 5September 2022ISSN: 0301-1526eISSN: 1664-2872 ReceivedApril 16, 2022AcceptedJune 10, 2022 InformationVasa (2022), 51, pp. 320-322 https://doi.org/10.1024/0301-1526/a001018.© 2022Hogrefe AGConflict of interestRMF, UA, EV, NM, MS, EA, GP, DM, SB declare no conflict of interests. MDN received honoraria for participation at advisory board from Bayer, Daiichi Sankyo, Pfizer, Leo Pharma, Sanofi, and Viatris, outside the submitted work.PDF download" @default.
• W4294578296 created "2022-09-05" @default.
• W4294578296 creator A5008150148 @default.
• W4294578296 creator A5030055327 @default.
• W4294578296 creator A5031228894 @default.
• W4294578296 creator A5032871496 @default.
• W4294578296 creator A5035786262 @default.
• W4294578296 creator A5036890928 @default.
• W4294578296 creator A5051320188 @default.
• W4294578296 creator A5055292769 @default.
• W4294578296 creator A5067848534 @default.
• W4294578296 creator A5090639944 @default.
• W4294578296 date "2022-09-01" @default.
• W4294578296 modified "2023-09-27" @default.
• W4294578296 title "Quality of warfarin anticoagulation in adults with short bowel syndrome on home parenteral nutrition" @default.
• W4294578296 cites W1511985826 @default.
• W4294578296 cites W1964199687 @default.
• W4294578296 cites W2067785801 @default.
• W4294578296 cites W2168790456 @default.
• W4294578296 cites W2343860594 @default.
• W4294578296 cites W2765762140 @default.
• W4294578296 cites W3192253543 @default.
• W4294578296 doi "https://doi.org/10.1024/0301-1526/a001018" @default.
• W4294578296 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/36059217" @default.
• W4294578296 hasPublicationYear "2022" @default.
• W4294578296 type Work @default.
• W4294578296 citedByCount "1" @default.
• W4294578296 countsByYear W42945782962022 @default.
• W4294578296 crossrefType "journal-article" @default.
• W4294578296 hasAuthorship W4294578296A5008150148 @default.
• W4294578296 hasAuthorship W4294578296A5030055327 @default.
• W4294578296 hasAuthorship W4294578296A5031228894 @default.
• W4294578296 hasAuthorship W4294578296A5032871496 @default.
• W4294578296 hasAuthorship W4294578296A5035786262 @default.
• W4294578296 hasAuthorship W4294578296A5036890928 @default.
• W4294578296 hasAuthorship W4294578296A5051320188 @default.
• W4294578296 hasAuthorship W4294578296A5055292769 @default.
• W4294578296 hasAuthorship W4294578296A5067848534 @default.
• W4294578296 hasAuthorship W4294578296A5090639944 @default.
• W4294578296 hasConcept C126322002 @default.
• W4294578296 hasConcept C177713679 @default.
• W4294578296 hasConcept C2776301958 @default.
• W4294578296 hasConcept C2779161974 @default.
• W4294578296 hasConcept C2779820108 @default.
• W4294578296 hasConcept C71924100 @default.
• W4294578296 hasConcept C78722104 @default.
• W4294578296 hasConceptScore W4294578296C126322002 @default.
• W4294578296 hasConceptScore W4294578296C177713679 @default.
• W4294578296 hasConceptScore W4294578296C2776301958 @default.
• W4294578296 hasConceptScore W4294578296C2779161974 @default.
• W4294578296 hasConceptScore W4294578296C2779820108 @default.
• W4294578296 hasConceptScore W4294578296C71924100 @default.
• W4294578296 hasConceptScore W4294578296C78722104 @default.
• W4294578296 hasIssue "5" @default.
• W4294578296 hasLocation W42945782961 @default.
• W4294578296 hasLocation W42945782962 @default.
• W4294578296 hasOpenAccess W4294578296 @default.
• W4294578296 hasPrimaryLocation W42945782961 @default.
• W4294578296 hasRelatedWork W2012207339 @default.
• W4294578296 hasRelatedWork W2025680102 @default.
• W4294578296 hasRelatedWork W2102762750 @default.
• W4294578296 hasRelatedWork W2382136405 @default.
• W4294578296 hasRelatedWork W2400029971 @default.
• W4294578296 hasRelatedWork W2463952885 @default.
• W4294578296 hasRelatedWork W4225966309 @default.
• W4294578296 hasRelatedWork W4292856676 @default.
• W4294578296 hasRelatedWork W4294578296 @default.
• W4294578296 hasRelatedWork W2026546052 @default.
• W4294578296 hasVolume "51" @default.
• W4294578296 isParatext "false" @default.
• W4294578296 isRetracted "false" @default.
• W4294578296 workType "article" @default.