High gas6 in plasma predicts venous thromboembolism recurrence, major bleeding and mortality in the elderly.

Schnegg-Kaufmann, A; Calzavarini, S; Limacher, A; Mean, M; Righini, M; Staub, D; Beer, J H; Frauchiger, B; Osterwalder, J; Kucher, N; Matter, C M; Husmann, M; Banyai, M; Aschwanden, M; Mazzolai, L; Hugli, O; Nagler, M; Daskalakis, M; Rodondi, N; Aujesky, D; ... (2019). High gas6 in plasma predicts venous thromboembolism recurrence, major bleeding and mortality in the elderly. Journal of thrombosis and haemostasis, 17(2), pp. 306-318. Wiley-Blackwell 10.1111/jth.14365

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BACKGROUND Growth arrest-specific gene 6 (Gas6) is a pro-hemostatic protein with an unknown predictive ability for recurrent venous thromboembolism (VTE). In the elderly, VTE carries a higher mortality but not a higher rate of VTE recurrence than in younger patients. Consequently, anticoagulation management in the elderly is challenging. OBJECTIVE To prospectively investigate the performance of Gas6 to predict VTE recurrence, major bleeding and mortality in the elderly. METHODS Consecutive patients aged ≥65 with acute VTE were followed over 3 years. Primary outcomes were symptomatic VTE recurrence, major bleeding and mortality. Plasmatic Gas6 was measured by ELISA. RESULTS Gas6 was measured in 864 patients at the time of the index VTE (T1) and in 70% of them, also 12 months later (T2). Gas6 at T1 was discriminatory for VTE recurrence (C-statistics: 0.56, 95% confidence interval [CI]: 0.51 to 0.62), major bleeding (0.60, 95%CI: 0.55 to 0.65) and mortality (0.69, 95%CI: 0.65-0.73) up to 36 months. VTE recurrence up to 24 months after T2 was discriminated by Gas6 at T2 (0.62, 95%CI: 0.54-0.71). High Gas6 (>157%) and continuous Gas6 levels at T1 were associated with VTE recurrence up to 6 and 12 months, respectively. CONCLUSIONS In elderly patients, high Gas6 is associated with a higher risk of VTE recurrence, major bleeding and death. These findings support urther studies to assess the performance of Gas6 for adjusting anticoagulation length. This article is protected by copyright. All rights reserved.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine
04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Haematology and Central Haematological Laboratory
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > Unit Childrens Hospital > Forschungsgruppe Hämatologie (Erwachsene)
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine
04 Faculty of Medicine > Pre-clinic Human Medicine > CTU Bern

UniBE Contributor:

Schnegg-Kaufmann, Annatina; Calzavarini, Sara; Limacher, Andreas; Nagler, Michael; Daskalakis, Michael; Rodondi, Nicolas; Aujesky, Drahomir and Angelillo, Anne

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

1538-7836

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

03 Jan 2019 12:14

Last Modified:

11 Feb 2019 11:04

Publisher DOI:

10.1111/jth.14365

PubMed ID:

30570809

Uncontrolled Keywords:

Growth arrest-specific gene 6 aged cohort studies mortality venous thromboembolism

BORIS DOI:

10.7892/boris.123147

URI:

https://boris.unibe.ch/id/eprint/123147

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