Abstract:
INTRODUCTION:A higher level of health insurance coverage may be related to better quality of care and outcomes. Whether insurance status is associated with anticoagulation quality and clinical outcomes in patients with venous thromboembolism (VTE) is unknown. METHODS:We studied 819 elderly patients treated with vitamin K antagonists for VTE in a Swiss prospective multicenter cohort (09/2009-12/2013). The study outcomes were the anticoagulation quality, defined as the time spent in the therapeutic INR range, and clinical events, i.e. the time to a first VTE recurrence, major bleeding, and mortality. We assessed the association between insurance status (private vs. general), anticoagulation quality, and clinical outcomes using regression models, adjusting for potential confounders. RESULTS:Although the unadjusted mean percentage of time spent in the therapeutic INR range (2.0-3.0) was slightly higher in patients with private vs. general insurance (65% vs. 61%; p = 0.030), the adjusted difference was not statistically significant (1.53%, 95% CI -1.97 to 5.04). Patients with private insurance had a lower 36-month cumulative incidence of major bleeding (9.7% vs. 15.7%; p = 0.018). After adjustment, privately insured patients had a lower risk of major bleeding compared to patients with general insurance (sub-hazard ratio 0.57, 95% CI 0.32 to 0.98). Insurance status was not associated with recurrent VTE or mortality. CONCLUSION:Privately insured patients spent somewhat more time in therapeutic INR range and had a lower rate of major bleeding than generally insured patients. Basic (general) health insurance may be a marker of lower anticoagulation quality and higher risk of major bleeding.
journal_name
Thromb Resjournal_title
Thrombosis researchauthors
Zumbrunn B,Stalder O,Méan M,Limacher A,Tritschler T,Rodondi N,Aujesky Ddoi
10.1016/j.thromres.2018.11.011subject
Has Abstractpub_date
2019-01-01 00:00:00pages
124-130eissn
0049-3848issn
1879-2472pii
S0049-3848(18)30604-2journal_volume
173pub_type
杂志文章,多中心研究abstract:BACKGROUND:Cerebral vein thrombosis (CVT) is a rare, life-threatening disease affecting one adult per 100,000 per year. Genetic risk factors are deficiencies of the natural anticoagulant proteins antithrombin, protein C, protein S or single nucleotide polymorphisms such as factor V Leiden and prothrombin 20210A. In 20%...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2018.06.011
更新日期:2018-09-01 00:00:00
abstract::Venous thromboembolism (VTE) is a common complication in patients with malignant disease. In addition to well-established acquired risk factors for VTE, several genetic risk factors, mainly related to the haemostatic system, are known to influence thrombotic risk. However, the contribution of gene abnormalities to thr...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/s0049-3848(03)00179-8
更新日期:2003-02-15 00:00:00
abstract::Blood was obtained from four patients envenomated by the Australian common brown snake, Pseudonaja textilis textilis. This elapid snake has one of the most toxic venoms in the world, containing extremely potent neurotoxic and coagulant components. The latter is a potent complete prothrombinase, converting prothrombin ...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(90)90399-w
更新日期:1990-09-01 00:00:00
abstract::Plasma homocysteine levels result from the effect of genetic and environmental factors. We investigated the hypothesis of familial association between folates, methylenetetrahydrofolate reductase (MTHFR) and hyperhomocysteinemia with acute events, studying three families through pedigree analysis and log-linear graphi...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/s0049-3848(01)00408-x
更新日期:2002-01-15 00:00:00
abstract::Plasma from patients with thrombotic thrombocytopenic purpura (TTP) caused the aggregation of washed human platelets, which was inhibited by preincubation with normal plasma. Using salt fractionation, ion exchange chromatography, and preparative agarose gel electrophoresis, we purified a protein from normal plasma whi...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(84)90155-5
更新日期:1984-01-01 00:00:00
abstract::When human citrated plasma is dialysed against a phosphate buffer containing Ca++, citrate anions are removed, thrombin is generated and soluble fibrinogen derivatives (fibrin monomers and/or soluble fibrin polymers) are formed. These derivatives are able to combine with human or bovine elastin to form a very stable a...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(86)90061-7
更新日期:1986-07-15 00:00:00
abstract::The activity of tissue plasminogen activator-plasminogen activator inhibitor-1 (t-PA-PAI-1) complex to convert plasminogen to plasmin was examined by using fibrin autography and casein zymography where plasminogen was added or removed for casein layer. Fibrin autography was more sensitive to the activity of t-PA even ...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(91)90279-6
更新日期:1991-07-01 00:00:00
abstract:INTRODUCTION:Pulmonary embolism (PE) has a high morbidity and mortality. Hence it is important to recognize factors associated with higher risk of adverse outcomes in hemodynamically stable patients. Heart-type fatty acid binding protein (H-FABP) is a novel marker evaluated in recent years for prognosis in acute PE. Ou...
journal_title:Thrombosis research
pub_type: 杂志文章,meta分析
doi:10.1016/j.thromres.2014.10.007
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:Postmenopausal hormone therapy is associated with many diseases and conditions, e.g., cardiovascular diseases and asthma, but the underlying molecular mechanisms are incompletely understood. The aim of the current study was to investigate the effect of four different postmenopausal hormone therapy regimens o...
journal_title:Thrombosis research
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.thromres.2011.12.009
更新日期:2012-07-01 00:00:00
abstract:BACKGROUND:Platelet microparticles (PMPs) possess proatherogenic and procoagulant properties which may play a role in atherogenesis and subsequent thromboembolic complications. The present study was conducted to investigate the possible relationship between carotid atherosclerosis and plasma concentrations of PMPs, and...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2008.10.016
更新日期:2009-04-01 00:00:00
abstract::We have previously reported on a microassay based on human kininogens as cysteine proteinase inhibitors (CPIs), which could quantify partially purified kininogens from different biological fluids (J Pharmacol Meth 26, 113-124, 1991). In the present study we describe a functional method that, when assuming a 1:1 stoich...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(96)00073-4
更新日期:1996-05-01 00:00:00
abstract:OBJECTIVES:Elevated plasma homocysteine has been implicated as a risk factor for hypertension. C677T polymorphism in methylenetetrahydrofolate reductase gene (MTHFR) is a major determinant of hyperhomocysteinemia, which results in endothelial dysfunction. Angiotensin-converting enzyme (ACE) inhibitors appear to remedy ...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2004.04.005
更新日期:2004-01-01 00:00:00
abstract::Using the standard turbidimetric method of platelet aggregation and quantitation of platelet secretion with 14C-Serotonin, we have examined the responsiveness of the platelets of mongrel dogs to arachidonic acid (AA), and the thromboxane agonist U46619 in the presence and absence of a subthreshold concentration of epi...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(89)90300-9
更新日期:1989-09-15 00:00:00
abstract::Increased fibrinolytic activity is a well recognized constant finding observed during cardiopulmonary bypass (CPB). The purpose of the present work was to study and estimate the factors involved in the plasminogen activation and prekallikrein-kallikrein systems in a population of adult patients undergoing open heart s...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(92)90018-6
更新日期:1992-09-01 00:00:00
abstract::Recent studies have demonstrated that neutrophilic granulocytes and platelets have the capability to interact with each other. Either type of cell may release soluble factors, which either activate the other or increase its response to separate stimulating agents. Direct contact between the two types of cell generally...
journal_title:Thrombosis research
pub_type: 杂志文章,评审
doi:10.1016/s0049-3848(10)80002-7
更新日期:1994-01-01 00:00:00
abstract::Contact angle measurements, histological examinations and platelet adhesion tests on native and glutaraldehyde-treated porcine aortic valve leaflets, are reported. Contact angles measured with water or saline on native and treated leaflets do not differ appreciably. Values of less than 10 degrees for both the dry and ...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(85)90058-1
更新日期:1985-04-15 00:00:00
abstract:INTRODUCTION:Hydrogen sulfide (H2S) known as a gasotransmitter is increasingly recognized for its anti-adhesive, anti-inflammatory and vasoactive properties. Due to these properties, we analysed anti-thrombotic effects of H2S and the participation of the nitric oxide synthase (NOS)-pathway. MATERIALS AND METHODS:In in...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2013.07.010
更新日期:2013-08-01 00:00:00
abstract::Sulfation of the natural polysaccharide curdlan results in anticoagulantly active beta-1,3-glucan sulfates whose activity depends on various structural parameters. In this study the anticoagulant and antithrombotic effects of one of these beta-1,3-glucan sulfates (GS) were compared with those of a porcine mucosal hepa...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(95)00049-w
更新日期:1995-05-01 00:00:00
abstract::Cardiovascular disease (CVD) includes a number of conditions such as myocardial infarction, coronary heart disease, stroke, and venous thromboembolism. CVD is a leading health problem worldwide and a major cause of mortality, morbidity, and disability; it is also associated with high healthcare costs. The incidence of...
journal_title:Thrombosis research
pub_type: 杂志文章,评审
doi:10.1016/j.thromres.2014.11.036
更新日期:2015-02-01 00:00:00
abstract::We previously reported that the expression of thrombomodulin on the MEG-01, a cell line from human megakaryoblastic leukemia, was increased by agents that increase intracellular cAMP. In this paper we examine the effect of these agents on cultured human umbilical vein endothelial cells (HUVEC) and mouse hemangioma cel...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(91)90107-8
更新日期:1991-02-01 00:00:00
abstract::The effects of desmopressin and dextran on haemostasis and fibrinolysis were studied in four healthy volunteers. Both drugs were compared to placebo, each volunteer being subject to four experiments. Dextran 70 (30 g i.v.) moderately decreased VIII:C and vWF:Ag and slightly increased antithrombin III, also when haemod...
journal_title:Thrombosis research
pub_type: 临床试验,杂志文章
doi:10.1016/0049-3848(91)90009-l
更新日期:1991-06-01 00:00:00
abstract::Platelet aggregation in platelet-rich plasma (PRP) is more sensitive to agonists and more resistant to antagonists than that in whole blood. In this study, we show that the presence of neutrophils in whole blood accounts at least in part for diminished platelet aggregation in whole blood. The platelet-inhibitory effec...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(90)90216-y
更新日期:1990-12-01 00:00:00
abstract::Studies of the factors affecting the first recurrence of ischemic stroke have reported inconsistent findings. Types of initial stroke and the racial differences in study samples are among the explanations that may account for this inconsistency. The aims of this study were to estimate the cumulative recurrence rates o...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/s0049-3848(99)00146-2
更新日期:2000-02-01 00:00:00
abstract::Activated platelets may adhere to leukocytes and form circulating mixed aggregates. The latter are considered a reliable marker of a prothrombotic state and are associated with several cardiovascular conditions. The molecular mechanisms responsible of this cellular interaction include a central role of platelet P-sele...
journal_title:Thrombosis research
pub_type: 杂志文章,评审
doi:10.1016/j.thromres.2011.10.010
更新日期:2012-03-01 00:00:00
abstract::Individuals with more than one defect in the natural anticoagulant system exhibit an increased risk for thrombosis. We report on a family with two cases of combined protein C (PROC) and protein S (PROS) deficiency, five cases of isolated PROC deficiency Type I, and two cases of isolated PROS deficiency Type I. PROC an...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/s0049-3848(01)00232-8
更新日期:2001-07-01 00:00:00
abstract:INTRODUCTION:Dabigatran (Dabi) is not routinely monitored. However, in emergency cases quantitative assessment is required and laboratories must provide suitable tests at all hours. Little is known about Dabi effects on thrombin generation. MATERIALS AND METHODS:Patient samples (n=241) were analyzed for functional Dab...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2015.04.032
更新日期:2015-07-01 00:00:00
abstract::The alpha-chymotrypsin-like proteinase from rat peritoneal mast cells (RMCP I) rapidly destroyed the normal clotting activity of purified, calcium-free, bovine prothrombin, human prothrombin and bovine factor X and simultaneously removed similar N-terminal peptides (Mr approximately 5,000) from both prothrombin and th...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(86)90007-1
更新日期:1986-11-01 00:00:00
abstract::In this paper, we demonstrated that the procoagulant action of Lonomia achelous (Cramer) is due in part to a component that activates prothrombin. The activation by crude venom and Fractions obtained by gel filtration on Sephadex G-75 is not dependent of phospholipid, Ca++ or Factor V. The activation of prothrombin by...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(92)90187-f
更新日期:1992-05-01 00:00:00
abstract::Platelets occupy a central role at the interface between thrombosis and inflammation. At sites of vascular damage, adherent platelets physically and functionally interact with circulating leukocytes. Activated platelets release soluble factors into circulation that may have local and systemic effects on blood and vasc...
journal_title:Thrombosis research
pub_type: 杂志文章,评审
doi:10.1016/j.thromres.2010.10.010
更新日期:2011-03-01 00:00:00
abstract::Numerous factors affect the response to vitamin K antagonists (VKA) including age, dietary vitamin K, other drugs, pharmacogenetics, and disease states. In antithrombotic guidelines, fever is mentioned as a factor that may increase response to VKA. The purpose of this article is to review the available evidence regard...
journal_title:Thrombosis research
pub_type: 杂志文章,评审
doi:10.1016/j.thromres.2014.10.015
更新日期:2015-01-01 00:00:00