What question did this study set out to answer?

To evaluate the rate, clinical characteristics, and risk factors of thrombotic events occurring in daily practice patients beginning oral anticoagulant therapy.

January 1, 1997Thrombosis and Haemostasis

Thrombotic Events during Oral Anticoagulant Treatment: Results of the Inception-cohort, Prospective, Collaborative ISCOAT Study

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Why the study?

What are the rates and predictors of thrombotic events in patients initiating oral anticoagulant treatment in daily practice?

Population

2,745 unselected, daily practice patients starting their first course of oral anticoagulant treatment…

Design

Cohort

Follow-up

2,011 patient-years (total)

Authors

GPGualtiero PalaretiVascular Medicine CMCesare ManottiUniversity of Parma ADArmando D’AngeloCross-Cutting Cardiology

Discussion

Member takes

Implication

Early OAC initiation and subtherapeutic INR warrant heightened monitoring; leaves open whether intensified strategies reduce events in routine practice.

Key Points

To evaluate the rate, clinical characteristics, and risk factors of thrombotic events occurring in daily practice patients beginning oral anticoagulant therapy.
Prospective, multicenter inception-cohort study enrolling 2,745 unselected patients beginning their first oral anticoagulant course across 34 anticoagulation clinics in Italy.
Followed patients over a cumulative duration of 2,011 patient-years of treatment to record fatal, major, and minor thrombotic complications.
A total of 70 thrombotic events occurred in 67 patients (3.5 per 100 patient-years), consisting of 20 fatal (1%), 39 major (1.9%), and 11 minor (0.6%) events.
Thrombotic risk was substantially elevated within the first 90 days of treatment compared to afterward (multivariate RR 20.6, 95% CI 12.7–33.5; p < 0.0001) and with INR < 2.0 versus > 2.0 (RR 1.88, 95% CI 1.16–3.07; p < 0.05).
Multivariate analysis showed increased risk in patients aged > 70 years (RR 1.62, 95% CI 1.0–2.61; p < 0.05) and those treated for peripheral or cerebral arterial disease (RR 1.84, 95% CI 1.01–3.36; p < 0.05).

Structured PICO

What are the rates and predictors of thrombotic events in patients initiating oral anticoagulant treatment in daily practice?

Population

2,745 unselected, daily practice patients starting their first course of oral anticoagulant treatment, referring to 34 Italian anticoagulation clinics

Intervention

Oral anticoagulant treatment

Outcome

Rate and type of thrombotic events (fatal, major, and minor)hard clinical

The risk of thrombotic events during oral anticoagulation is highest in the first 90 days of therapy, in older patients, and when INR is subtherapeutic (<2.0).

Cite This Study

Palareti et al. (1997) studied this question.

synapsesocial.com/papers/6a7e4be416134f106bf71530 https://doi.org/10.1055/s-0038-1665430

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Implication

Early OAC initiation and subtherapeutic INR warrant heightened monitoring; leaves open whether intensified strategies reduce events in routine practice.

Thrombotic Events during Oral Anticoagulant Treatment: Results of the Inception-cohort, Prospective, Collaborative ISCOAT Study

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Thrombotic Events during Oral Anticoagulant Treatment: Results of the Inception-cohort, Prospective, Collaborative ISCOAT Study

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider