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  1. Article ; Online: Anticoagulation in Patients with Isolated Distal Deep Vein Thrombosis: Bringing the Puzzle Together.

    Potere, Nicola / Yamashita, Yugo / Ageno, Walter

    Thrombosis and haemostasis

    2024  

    Language English
    Publishing date 2024-02-07
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 518294-3
    ISSN 2567-689X ; 0340-6245
    ISSN (online) 2567-689X
    ISSN 0340-6245
    DOI 10.1055/a-2250-3298
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  2. Article ; Online: How to treat isolated distal deep vein thrombosis.

    Potere, Nicola / Ageno, Walter

    Polish archives of internal medicine

    2023  Volume 133, Issue 7-8

    Abstract: Isolated distal deep vein thrombosis (IDDVT) is a frequent manifestation of venous thromboembolism (VTE), accounting for up to 50% cases of lower‑extremity deep vein thrombosis (DVT). As compared with proximal DVT, IDDVT is more frequently associated ... ...

    Abstract Isolated distal deep vein thrombosis (IDDVT) is a frequent manifestation of venous thromboembolism (VTE), accounting for up to 50% cases of lower‑extremity deep vein thrombosis (DVT). As compared with proximal DVT, IDDVT is more frequently associated with transient risk factors and less often occurs unprovoked or in the presence of permanent risk factors. IDDVT generally carries a significantly lower risk of proximal extension, post‑thrombotic syndrome, and recurrence than proximal DVT. Nevertheless, some patient subgroups, such as those with active cancer, other predisposing permanent risk factors, prior VTE, unprovoked IDDVT, persistently restricted mobility, and trifurcation or bilateral involvement, exhibit a non‑negligible recurrence risk. Unlike in proximal DVT, the optimal therapeutic management of IDDVT remains uncertain. In clinical practice, the vast majority of IDDVT patients are managed with anticoagulation rather than with surveillance serial compression ultrasonography, which tends to be reserved to individuals at a high bleeding risk. Available data seem to favor anticoagulant therapy over no anticoagulation, thanks to a significant reduction in the risk for proximal extension and recurrence, without increased bleeding risk. Recent results of the RIDTS (Rivaroxaban for the Treatment of Symptomatic Isolated Distal Deep Vein Thrombosis) randomized clinical trial with rivaroxaban further support the use of anticoagulant therapy for 3 months over shorter durations (eg, ≤6 weeks). In this review, we offer an updated overview of the epidemiology, risk factors, and clinical course of IDDVT, with a focus on the therapeutic management in light of current guideline recommendations and most recent evidence. We also present real‑life clinical cases of IDDVT with proposed therapeutic approaches, and highlight major challenges and gaps in this field.
    MeSH term(s) Humans ; Venous Thromboembolism/epidemiology ; Rivaroxaban/therapeutic use ; Recurrence ; Venous Thrombosis/drug therapy ; Anticoagulants/therapeutic use ; Hemorrhage ; Randomized Controlled Trials as Topic
    Chemical Substances Rivaroxaban (9NDF7JZ4M3) ; Anticoagulants
    Language English
    Publishing date 2023-08-07
    Publishing country Poland
    Document type Review ; Journal Article
    ZDB-ID 123500-x
    ISSN 1897-9483 ; 0032-3772
    ISSN (online) 1897-9483
    ISSN 0032-3772
    DOI 10.20452/pamw.16543
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  3. Article ; Online: Blood Hyperviscosity: A Novel Link Between Hyperinflammation and Hypercoagulability in COVID-19.

    Bonaventura, Aldo / Potere, Nicola

    Journal of the American College of Cardiology

    2022  Volume 80, Issue 4, Page(s) 329–331

    MeSH term(s) COVID-19/complications ; Humans ; SARS-CoV-2 ; Thrombophilia/etiology
    Language English
    Publishing date 2022-07-18
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 605507-2
    ISSN 1558-3597 ; 0735-1097
    ISSN (online) 1558-3597
    ISSN 0735-1097
    DOI 10.1016/j.jacc.2022.04.061
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  4. Article ; Online: Geographical and ethnoracial differences in venous thromboembolism and anticoagulation: An expanding horizon.

    Potere, Nicola / Donadini, Marco Paolo / Ageno, Walter

    European journal of internal medicine

    2023  Volume 118, Page(s) 43–45

    MeSH term(s) Humans ; Venous Thromboembolism/drug therapy ; Blood Coagulation ; Anticoagulants/therapeutic use ; Health Services
    Chemical Substances Anticoagulants
    Language English
    Publishing date 2023-10-31
    Publishing country Netherlands
    Document type Journal Article ; Comment
    ZDB-ID 1038679-8
    ISSN 1879-0828 ; 0953-6205
    ISSN (online) 1879-0828
    ISSN 0953-6205
    DOI 10.1016/j.ejim.2023.10.028
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  5. Article: Anticoagulation in Patients with Isolated Distal Deep Vein Thrombosis: Bringing the Puzzle Together

    Potere, Nicola / Yamashita, Yugo / Ageno, Walter

    Thrombosis and Haemostasis

    2024  

    Language English
    Publishing date 2024-01-19
    Publisher Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 518294-3
    ISSN 2567-689X ; 0340-6245
    ISSN (online) 2567-689X
    ISSN 0340-6245
    DOI 10.1055/a-2250-3298
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  6. Article ; Online: Venous thromboembolism in pancreatic cancer patients: Time to consider routine thromboprophylaxis?

    Di Nisio, Marcello / Potere, Nicola / Porreca, Ettore

    European journal of internal medicine

    2022  Volume 105, Page(s) 23–24

    MeSH term(s) Humans ; Venous Thromboembolism/prevention & control ; Venous Thromboembolism/drug therapy ; Anticoagulants/therapeutic use ; Risk Factors ; Blood Coagulation Tests ; Pancreatic Neoplasms/complications
    Chemical Substances Anticoagulants
    Language English
    Publishing date 2022-09-29
    Publishing country Netherlands
    Document type Journal Article ; Comment
    ZDB-ID 1038679-8
    ISSN 1879-0828 ; 0953-6205
    ISSN (online) 1879-0828
    ISSN 0953-6205
    DOI 10.1016/j.ejim.2022.09.015
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  7. Article ; Online: Anamnestic frailty phenotype and adverse outcomes in patients treated with direct oral anticoagulants: Validation and comparative performance with frailty phenotype.

    Candeloro, Matteo / Di Nisio, Marcello / Potere, Nicola / Federici, Camilla / Auciello, Raffaella / Porreca, Ettore

    Archives of gerontology and geriatrics

    2023  Volume 108, Page(s) 104945

    Abstract: Aims: The anamnestic frailty phenotype (AFP) is a quick, instrument-free tool derived from frailty phenotype (FP). We prospectively evaluated the discriminative capacity and prognostic value of AFP in ambulatory patients receiving DOACs for atrial ... ...

    Abstract Aims: The anamnestic frailty phenotype (AFP) is a quick, instrument-free tool derived from frailty phenotype (FP). We prospectively evaluated the discriminative capacity and prognostic value of AFP in ambulatory patients receiving DOACs for atrial fibrillation (AF) or venous thromboembolism (VTE), and compared AFP performance with that of FP.
    Methods and results: Sensitivity, specificity, positive and negative predictive value (PPV, NPV) with corresponding 95% confidence intervals (95%CI), were estimated for bleeding, thromboembolism, and all-cause mortality. Risk ratios (RRs) were calculated in frail versus non-frail patients. Of 236 patients (median age 78 years), 98 (42%) and 89 (38%) were classified as frail according to FP and AFP, respectively (Kappa= 0.76). Frailty, as assessed by AFP, was associated with higher risk of bleeding (RR 2.3; 95%CI, 1.2 to 4.6), and mortality (RR 4.4; 95%CI, 1.3 to 19.7). Similarly, to FP, AFP exhibited modest sensitivity and specificity, but high NPV that was 91% (95%CI, 85 to 95) for bleeding, 98% (95%CI, 94 to 100) for thromboembolism, and 98% (95%CI, 94 to 100) for mortality.
    Conclusion: Among patients receiving DOACs for AF or VTE, AFP was associated with an increased risk of adverse outcomes. AFP exhibited modest sensitivity and specificity, but excellent NPV. If confirmed, these findings suggest that AFP may represent a rapid, easy-to-use and unexpensive tool that may potentially help identify patients at lower risk for adverse outcomes and tailor anticoagulation management.
    MeSH term(s) Humans ; Anticoagulants ; Venous Thromboembolism/chemically induced ; Venous Thromboembolism/complications ; Frailty/complications ; alpha-Fetoproteins ; Hemorrhage/chemically induced ; Hemorrhage/complications ; Atrial Fibrillation
    Chemical Substances Anticoagulants ; alpha-Fetoproteins
    Language English
    Publishing date 2023-01-25
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 603162-6
    ISSN 1872-6976 ; 0167-4943
    ISSN (online) 1872-6976
    ISSN 0167-4943
    DOI 10.1016/j.archger.2023.104945
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    Zs.A 1729: Show issues Location:
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  8. Article ; Online: Management of upper extremity deep vein thrombosis: an updated review of the literature.

    Potere, Nicola / Candeloro, Matteo / Porreca, Ettore / DI Nisio, Marcello

    Minerva medica

    2021  Volume 112, Issue 6, Page(s) 746–754

    Abstract: Upper extremity deep vein thrombosis (UEDVT) represents about 5-10% of all cases of deep vein thrombosis (DVT) with a steadily increasing incidence mostly due to the high prevalence of cancer and frequent use of intravascular devices such as central ... ...

    Abstract Upper extremity deep vein thrombosis (UEDVT) represents about 5-10% of all cases of deep vein thrombosis (DVT) with a steadily increasing incidence mostly due to the high prevalence of cancer and frequent use of intravascular devices such as central venous catheters and pacemaker. In primary UEDVT, the venous outflow obstruction and subsequent thrombosis are related to congenital or acquired anatomical abnormalities, whereas secondary UEDVT is often associated with malignancy or indwelling lines. A considerable proportion of patients with UEDVT develops serious complications such as recurrent thrombosis, post-thrombotic syndrome, and pulmonary embolism, therefore timely diagnosis and adequate treatment are of crucial importance. Despite sharing many similarities with lower extremity DVT, UEDVT has distinctive features requiring specific diagnostic and therapeutic approaches. The present review discusses the latest evidence on the epidemiology, diagnosis, and treatment of UEDVT, and provides management indications which may help guide clinical decision making.
    MeSH term(s) Humans ; Upper Extremity Deep Vein Thrombosis/diagnosis ; Upper Extremity Deep Vein Thrombosis/epidemiology ; Upper Extremity Deep Vein Thrombosis/therapy
    Language English
    Publishing date 2021-05-10
    Publishing country Italy
    Document type Journal Article ; Review
    ZDB-ID 123586-2
    ISSN 1827-1669 ; 0026-4806
    ISSN (online) 1827-1669
    ISSN 0026-4806
    DOI 10.23736/S0026-4806.21.07578-9
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  9. Article ; Online: Inflammasome Signaling, Thromboinflammation, and Venous Thromboembolism.

    Potere, Nicola / Abbate, Antonio / Kanthi, Yogendra / Carrier, Marc / Toldo, Stefano / Porreca, Ettore / Di Nisio, Marcello

    JACC. Basic to translational science

    2023  Volume 8, Issue 9, Page(s) 1245–1261

    Abstract: Venous thromboembolism (VTE) remains a major health burden despite anticoagulation advances, suggesting incomplete management of pathogenic mechanisms. The NLRP3 (NACHT-, LRR- and pyrin domain-containing protein 3) inflammasome, interleukin (IL)-1, and ... ...

    Abstract Venous thromboembolism (VTE) remains a major health burden despite anticoagulation advances, suggesting incomplete management of pathogenic mechanisms. The NLRP3 (NACHT-, LRR- and pyrin domain-containing protein 3) inflammasome, interleukin (IL)-1, and pyroptosis are emerging contributors to the inflammatory pathogenesis of VTE. Inflammasome pathway activation occurs in patients with VTE. In preclinical models, inflammasome signaling blockade reduces venous thrombogenesis and vascular injury, suggesting that this therapeutic approach may potentially maximize anticoagulation benefits, protecting from VTE occurrence, recurrence, and ensuing post-thrombotic syndrome. The nonselective NLRP3 inhibitor colchicine and the anti-IL-1β agent canakinumab reduce atherothrombosis without increasing bleeding. Rosuvastatin reduces primary venous thrombotic events at least in part through lipid-lowering independent mechanisms, paving the way to targeted anti-inflammatory strategies in VTE. This review outlines recent preclinical and clinical evidence supporting a role for inflammasome pathway activation in venous thrombosis, and discusses the, yet unexplored, therapeutic potential of modulating inflammasome signaling to prevent and manage VTE.
    Language English
    Publishing date 2023-06-07
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 2452-302X
    ISSN (online) 2452-302X
    DOI 10.1016/j.jacbts.2023.03.017
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  10. Article ; Online: Age- versus clinical pretest probability-adjusted D-dimer to rule out lower-extremity deep vein thrombosis in ambulatory patients with active cancer.

    Di Nisio, Marcello / Candeloro, Matteo / Potere, Nicola / Federici, Camilla / Rutjes, Anne W S / Guglielmi, Maria Domenica / Porreca, Ettore

    Thrombosis research

    2023  Volume 225, Page(s) 22–27

    Abstract: Background: In patients with suspected deep vein thrombosis (DVT), D-dimer thresholds adjusted to age or clinical pretest probability (CPTP) increase the proportion of patients in whom DVT can be safely excluded compared to a standard approach using a ... ...

    Abstract Background: In patients with suspected deep vein thrombosis (DVT), D-dimer thresholds adjusted to age or clinical pretest probability (CPTP) increase the proportion of patients in whom DVT can be safely excluded compared to a standard approach using a fixed D-dimer threshold. Performance of these diagnostic strategies among cancer patients is uncertain.
    Aim: To compare the performance of age- and CPTP-adjusted D-dimer approaches among cancer outpatients with clinically suspected DVT, and derive a cancer-specific CPTP rule.
    Patients and methods: Consecutive ambulatory patients with active cancer and clinically suspected DVT of the lower extremity underwent CPTP assessment using the Wells rule, D-dimer testing, and whole-leg compression ultrasonography. Patients with normal ultrasonography were followed-up for 3 months for the occurrence of symptomatic venous thromboembolism.
    Results: Upon referral, DVT was diagnosed in 48 of 239 (20.1 %) patients. The age-adjusted approach showed higher specificity and efficiency than the standard approach. Compared to the standard and age-adjusted strategies, the CPTP-adjusted approach had 35 % and 21 % higher specificity, and 34 % and 21 % higher efficiency, respectively. Failure rate, sensitivity, and predictive values were similar across strategies. A simplified CPTP score derived from the Wells rule reduced unnecessary imaging with similar accuracy and efficiency, but higher failure rate.
    Conclusions: In this prospective cohort of ambulatory cancer patients with clinically suspected DVT, the CPTP-adjusted D-dimer approach held the highest specificity and efficiency, potentially safely reducing unnecessary ultrasonography examinations compared to other approaches. Additional studies are warranted to evaluate the use of a simplified clinical prediction rule in this setting.
    MeSH term(s) Humans ; Prospective Studies ; Venous Thrombosis/diagnostic imaging ; Fibrin Fibrinogen Degradation Products ; Ultrasonography ; Probability ; Lower Extremity ; Neoplasms/complications ; Predictive Value of Tests
    Chemical Substances fibrin fragment D ; Fibrin Fibrinogen Degradation Products
    Language English
    Publishing date 2023-03-13
    Publishing country United States
    Document type Journal Article
    ZDB-ID 121852-9
    ISSN 1879-2472 ; 0049-3848
    ISSN (online) 1879-2472
    ISSN 0049-3848
    DOI 10.1016/j.thromres.2023.03.002
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