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J Med Vasc. 2017 Feb;42(1):6-13. doi: 10.1016/j.jdmv.2017.01.002. Epub 2017 Apr 18.

[Venous thromboembolic disease: Comparison of management practices in France, Italy and Spain].

[Article in French]

Author information

1
Service de médecine vasculaire, hôpital de Rangueil, CHU de Toulouse, 1, avenue du Professeur-Jean-Poulhès, TSA 50032, 31059 Toulouse cedex 9, France; Consultations de médecine vasculaire, Centre cardiologique du Nord, 32-36, rue des Moulins-Gémeaux, 93200 Saint-Denis, France. Electronic address: doc.maurizot@gmail.com.
2
Service de médecine vasculaire, hôpital de Rangueil, CHU de Toulouse, 1, avenue du Professeur-Jean-Poulhès, TSA 50032, 31059 Toulouse cedex 9, France.
3
Service de médecine vasculaire, hôpital de Rangueil, CHU de Toulouse, 1, avenue du Professeur-Jean-Poulhès, TSA 50032, 31059 Toulouse cedex 9, France; Centre de consultation médicale spécialisée Delta Medical, rue Habib Chatti, Manar II, Tunis, Tunisie.
4
SAINBIOSE, DVH, Inserm, département de médecine et thérapeutique, hôpital Nord, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France.
5
ISABIAL, Department of Clinical Medicine, Universidad Miguel Hernández, Hospital General Universitario Alicante, Alicante, Espagne.
6
Department of Emergency Internal Medicine, Ospedale St. John, Rome, Italie.
7
Department of Internal Medicine, Hospital Universitario 12 de Octubre, Madrid, Espagne.
8
Department of Pneumonology, Complejo Hospitalario de Navarra, Pamplona, Espagne.
9
Department of Internal Medicine. Hospital de la Agencia Valenciana de Salud Vega Baja, Alicante, Espagne.
10
Department of Internal Medicine, Hospital Universitario Germans Trias i Pujol de Badalona, Universidad Católica de Murcia, Murcia, Espagne.

Abstract

BACKGROUND:

Many national and international guidelines have been established for venous thromboembolic disease (VTE). Homogeneous management practices could be expected in the different European countries. To verify this hypothesis, we compared practices in France, Italy and Spain.

METHOD:

We used data from the international RIETE registry to compare VTE management between France, Italy and Spain.

RESULTS:

From 2001 January to 2011 January, patients were consecutively included in France (n=1548), Italy (n=2083) and Spain (29,824). All patients received anticoagulant treatment. Low molecular-weight heparin (LMWH) was the most frequently used drug as initial therapy in all three countries, but unfractionated heparin (UFH) was more frequently used in France and Italy than in Spain. In France, the proportion of patients receiving LMWH was lower than the proportion of patients with active cancer (cancer 22.5 %, long-term treatment with LMWH 17.4 %). A vena cava filter was significantly more frequently used in France (5.5 % in France, 3.2 % in Italy and 2 % in Spain, P<0.0001). High bleeding risk because of surgery with recent thromboembolic disease was the most frequent indication in France and Italy for vena cava filter placement (36.4 %, and 31.3 %, respectively).

CONCLUSION:

Despite the publication of national and international guidelines, VTE management differs among the three major European countries included in the RIETE registry, France, Italy and Spain.

KEYWORDS:

Filter cava; Filtre cave; Héparine de bas poids moléculaire; Low molecular weight heparin; Maladie thromboembolique veineuse; Venous thromboembolism disease

PMID:
28705449
DOI:
10.1016/j.jdmv.2017.01.002

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