MI 20.

21: o ano em revista

Doença Vascular
Pulmonar
VTE: 2020 a year in review

Carolina Guedes
Coordenadora do NEDVP/SPMI
Assistente Hospitalar de Medicina Interna – ULSM/Hospital
de Pedro Hispano
VTE: 2020 a year in review

Summary

▪ Extended treatment: To Whom? How?

▪ Major Bleeding and DOAC’s: is there a way to predict?

▪ Cancer-associated VTE prophylaxis and treatment what’s new

Extended treatment: to whom?

▪ Except L-TRRiP all have high

risk of bias
▪ No real predictive value
▪ HERDOO2 score/Vienna
Prediction Model useful to
▪ RPVO after PE > 5% predictor of recurrence
identify patients with low risk of
recurrence in the unprovoked ▪ Predictors for RPVO > 5%: age > 65 (p<
VTE group (< 5%) 0,001), IPVO >20% (p< 0,001) and chronic
respiratory failure (p=0,011)
▪ Limitations: selection bias, baseline
characteristics
Extended treatment: how?
▪ DOAC’s therapy in extended
treatment:
▪ Reduces risk of recurrent VTE
▪ May increase CRNMB
▪ No difference in MB
Major Bleeding and DOAC’s: is there a way to
predict?

▪ MB 2.8% patient-year
▪ Predictors MB: Anemia, bleeding
history and creatinine clearance
<60 ml/min
▪ Predictive value of bleeding risk
scores: modest
▪ The VTE-BLEED score < 2 points
identified patients at low risk for MB
Cancer-associated VTE prophylaxis: what’s new
Cancer-associated VTE treatment: what’s new
▪ DOAC’s 32% lower risk of
recurrent VTE/ 36% higher risk
of MB
▪ DOAC’s avoided in patients at
high risk of bleeding
▪ Potencial drug –drug interaction
 Q&A
VTE: 2020 a year in review

Carolina Guedes
Coordenadora do NEDVP/SPMI
Assistente Hospitalar de Medicina Interna – ULSM/Hospital de Pedro Hispano
carolina.guedes@ulsm.min-saude.pt