| Title: |
Patients treated with vitamin K oral anticoagulants in family practice: a new approach to bleeding risk assessment. An ancillary study by the CACAO prospective general practice cohort |
| Authors: |
Gaboreau, Yoann; Frappé, Paul; Vermorel, Celine; Foote, Alison; Bosson, Jean-Luc; Pernod, Gilles; Abenhaïm, Nathan; Ackermann, Sophie; Adam Blanpain, Maryse; Andreu, Xavier; Arnould, Céline; Atlan-Cottin, Audrey; Aubert, Jean-Pierre; Aubin-Auger, Isabelle; Aubry, Jacques; Augueux, Julien; Augustin, Veena; Bakry, Annick; Baldesi, Marine; Banoun, Eric; Barberet, Eric; Bardet, Rémi; Barriere, Florence; Baruch, Dan; Baude, Nicolas; Bayen, Marc; Bayen, Sabine; Bayle, François; Beaufils, Yannick; Beaupin, Alain; Bedel-Chauvaud, Julie; Bel, Raphaël; Bellier, Martine; Bendamene, Farouk; Berard, Philippe; Berbé, Cédric; Berkhout, Christophe; Berland, Jacques; Béthembos, Charles-Edouard; Billiard, Pierre-Yves; Bisch, Olivier; Bizeau, Aurélie; Blanchard, Paul; Blanquart, Guy; Boch, Aurélie; Bodein, Isabelle; Boige, Emmanuel; Bonin, Claude; Bonis, Anne-Laure; Bonnard, Marie-Pierre; Bonnet, Pascal; Bonnet, Pierre-André; Bosselut, Gérard; Bottet, Anne; Bouche, Philippe; Boucherle, Bérengère; Bougeard, Audrey; Bouhana, Serge; Boukeloul, Mourad; Boulet-Gercourt, Jean; Boulongne, Jean-Marie; Bouniol, Lionel; Bourcart, Jean-Jacques; Bourgoin, Michel; Bourguignon-Vartanian, Véronique; Bouteville, Claire; Boutin, Philippe; Boutmy, Annelore; Brenner-Girault, Evelyne; Breton, Nicolas; Briane-Fraysse, Muriel; Brodbeck, Marina; Brunet, Olivier; Buchinger, Ariel; Buffaz-Sutra, Anne; Bur, Marc; Cabourdin, Philippe; Cachera, Philippe; Cailliez, Eric; Calafiore, Matthieu; Calvet, Denis; Camedescasse, Pierre; Canart, Hervé; Cancade, Michel; Candelier, Christophe; Capiod, Christian; Carin, Thierry; Caron, Olivier; Carré, Elisa; Carrillo, Yannick; Casagrande, Nathalie; Causse, Pierre; Chabert, Gaëlle; Chabord, Frédérick; Chambe, Juliette; Chambon, Guillaume; Champeaux, Richard; Charbonnel, Laurent; Charles, Rodolphe; Charra, Clément; Chartier, Samuel; Chastang, Julie; Chatelard, Sophia; Chatillon, Eric; Chauvot, Laurent; Chelle, Hervé; Chenuet, Stéphane; Chevalier, Nicolas; Chevillot, David; Cibeer, Jean-Pierre; Cittée, Jacques; Claudel, Jean-François; Clemence, Yvonnick; Clerget, Jean-Paul; Clusier-Jeudy, Isabelle; Coispeau, Marie-Pierre; Colin, Arnaud; Collart-Dutilleul, Hervé; Compagnon, Laurence; Compan Malet, Marine; Connan, Laurent; Conrad, Hubert; Coquillaud, Bruno; Cormier, Jean-Luc; Couette, Jean-Charles; Cournoyer, Yves; Cousin, Christian; Creton, Stephen; Crignon, Jean-Jacques; Cros, André; Cunin, Michel; Cussac, Emmanuel; Dailly, Jean-Maurice; Danvin, Didier; Darnaut, Pierre-Marie; Daubin, Bruno; de L’hamaide, Thomas; de Saint Meleuc, Yves; de Taddeo, Sabine; Decker, Jean-Luc; Decobert, Anne; Delattre, Yannick; Delavenne, Christine; Delavenne, Loïc; Delbru, Bénédicte; Deleplanque, Denis; Delerive, Nicole; Delesalle, Laurent; Delforge, François; Delgrange, Jean-Paul; Delpierre, Jean-Pierre; Demeulemeester, Eric; Derain, Nicolas; Descombe, Fabrice; Desmoulins, Thierry; Deville-Carollo, Marie-Claire; Dherbecourt, Jean-Michel; Didierjean, Michael; Domrane, Salima; Douzou, Brigitte; Druart, Sabine; Dubeau, Xavier; Dubedat, Arnaud; Dudragne, Résika; Duez, Christian; Dufour, Lucien; Duhamel, Sylvie; Duisit, Lionel; Dumoitier, Nathalie; Dumond, Hervé; Dumortier, Julien; Duquesne, Emilie; Durand, David; Durieux, William; Durot, Philippe; Duss, Taous; Eschalier, Bénédicte; Espiard, Eric; Eterstein, Pierre; Etienney, Joël; Faidix, Xavier; Famery, Patrice; Faria, David; Faure, Renaud; Ferrer, André; Ferrer, Jean-Marie; Feuillet, Jean; Fivel, Christian; Flaissier, Christian; Fortané, Julien; Forté, Jenny; Fossé, Claude; Foucat, Joël; Fouillard, Christophe; Fournier, Vianney; Fournier, Virginie; Fraizy, Déborah; Frenoy-Sansarricq, Isabelle; Gabbai, Bernard; Gaillard, Fabien; Garnier, Isabelle; Garnier, Jean-Michel; Gascoin, Jean-Claude; Gault, Yves; Gaultier, Martine; Gay, Bruno; Gédon, Benoît; Genies, Christophe; Géniole, Jean-Marc; Gentner, Jean-Luc; Ghez, Jean-Louis; Giraldi, Charles; Girard, Christian; Giraud, Philippe; Godart, Sylvain; Goidin, Pierre; Gomez, Aline; Goncalves, Céline; Gouget, Arnaud; Gouget, Marie-Laure; Gournay, Sylvain; Grand, Florence; Granier, Jean-Claude; Greffe, Roland; Grutter, Sabine; Gryb, Catherine; Guedel, François-Xavier; Guérin, Mathieu; Guiberteau, Julien; Guille, Jean-François; Guillot, Jean-Pierre; Guillou, Philippe; Gustin, Gilles; Guyot, Anne; Guyot, Jean-Marie; Hardy, Christophe; Hassid, David; Hayani, Latifa; Heller, Anne; Henriot, Frédéric; Hermouet, Thierry; Hoenner Hecht, Bénédicte; Honvoh Senadjro, Ferreol; Houdard, Gaëtan; Huas-Suarez, Isabelle; Huber, Corinne; Imbert, Patrick; Jacques, Pascal; Jacquet, Cécile; Jacquet, Jean-Pierre; Jacquiot, Denis; Jacquot, Philippe; Jaffre, Samy; Jean, Clémence; Jeanmougin, Pauline; Jeudy, Isabelle; Joseph, Jean-Philippe; Jouannic, Pierre; Jousson, Stéphanie; Kastelik, André; Klifa, Gérard; Knockaert, François-René; Koch, Jean-Philippe; Krotoff, Julia; Labrune, Charlotte; Lacaille-Smerilli, Véronique; Lacoin, François; Lainé, Xavier; Lambert, Philippe; Lambourg, Audrey; Lamy, Dominique; Lapenne-Creusot, Myriam; Laporte, Jean-Dominique; Lartaud, Lucie; Lauchet, Nadège; Lavielle, Dorothée; Le Breton, Julien; Le Diagon, Raphaël; Le Du, Marie; Le Goff, Delphine; Le Lann, Claire; Le Mouël, Stéphane; Leblan-Depelsenaire, Carole; Leclercq, Frédéric; Lécutier, Rudolphe; Ledoux, Jean-Nicolas; Lefebvre, Jean-Marc; Léger, Pascal; Lendais, Robert; Lengagne, Eric; Sosiewicz-Lengsavath, Catherine; Lenoir, Sylvie; Lerouge, Patrick; Leroy, Benoît; Leung-Y-Tai, Ida; Ligier, Pascal; Lobel, Charlotte; Loez, François; Lognos, Béatrice; Luaces, Baptiste; Lucas-Couturier, Laurence; Lunven, Anne; Machraoui, Sigolène; Maciejewski, André; Magnen, Loïc; Makridis, Georgios; Malbrunot, Jean-Luc; Mancini, Jean-Marc; Mangin, Hervé; Maniglier, Jean-Marc; Marchant, Philippe; Marcus, Julie; Marien, Guillaume; Martin-Etzol, Anne-Laure; Mas, Christian; Masset, Yannick; Massin, Pierre; Masson, Bruno; Mattera, Agnès; Matz, Charlotte; Maufoy, François; Maury, Collette; Mavraganis, Laure-Emmanuelle; Mazin, Olivier; Mazué, Lison; Melizan, Jean-Philippe; Menard, Dominique; Mercier, Alain; Mercier, Patricia; Meyer, Patric-Alain; Michellier, Philippe; Milleret, Corinne; Millot, Yannick; Minard, Françoise; Miqueu, Marie-Léa; Mismacque, Dany; Mitifiot, Catherine; Moebs, Jean-Louis; Monnier, Jean-Michel; Montariol, Yves; Montauze, Jérémie; Morand, Alain; Morel, Gilles; Morlon, François; Mortas, Delphine; Motte, Baptiste; Mouget, Stéphane; Munro, Luc; Naessens, Martin; Nammathao, Bounthanousone; Negre, Dominique; Nogrel, Charlie; Nouvellet, Lucile; Nureni Banafunzi, Ismaël; Oger, Thierry; Ortholan, Jean-François; Osty, Dominique; Oude Engberink, Agnès; Paillard, Guy-Marc; Paillard, Laurent; Pautout-Guillaume, Marie-Paule; Pech-Gourg, Laurent; Perdrix, Corinne; Perez, Véronique; Perrillat-Amédé, Ségolène; Peyrou, Christophe; Pichat, Bruno; Pigache, Christophe; Pinot, Alexis; Piquard, Dominique; Piquet, Thierry; Placet, Michel; Plauchier, Michel; Pluskota, Caroline; Ponchant, Maurice; Prat, Chantal; Prevost, Martine; Prigent, Jean-Pierre; Py, Thibaut; Rafin, Christian; Rambaud, Jacques; Rapoud, Jean-Paul; Regnier, Anne-Marie; Renaudin, Sylvain; Rétaux, Jean-Michel; Richard, Amélie; Richetta, Philippe; Rigault, Jean-Michel; Rigoli, Reinold; Ritter-Meinicke, Anne; Robert, Sarah; Rollin, Stéphanie; Rondepierre, Didier; Rosenberg, Sophie; Roth, Mélanie; Rougerie, Fabien; Royer de Vericourt, Guillaume; Rudelle, Karen; Ruelle, Philippe; Ruetsch, Marcel; Saillard, Dominique; Saint-Denis, Pénélope; Sannelli, Pietro; Saraidarian, Philippe; Sastourné, Jean-Pascal; Sauvage, Laurent; Scellier, Christian; Schaal, Christian; Schelcher, François-Xavier; Schirlin, Daniel; Schirrer, Anne; Schlienger, Claude; Schlienger, Joëlle; Serayet, Philippe; Serramoune, Denis; Siebler, Marlène; Simon, Jean-Paul; Soares, André; Soussotte-Ducasse, Carine; Stefanuto, Philippe; Steinberger, Marc; Szapiro, Marianne; Taha, Anas; Taluy, Erol; Tanguy, Gilles; Tardieux, Dominique; Tardy, Michel; Tavernier, Benoît; Ténédos, Jean-Luc; Thelot-Bach, Lorène; Tisserand, Rémy; Tordoir, Audrey; Trillot, François; Triouleyre, Pascal; Truong, David; Turi, Laurent; Vaillant, Frédéric; Vaillant-Roussel, Hélène; Vailler, Pierre; Vallee, Josette; Vampouille, Muriel; Vangi, Jean-Louis; Vannier, Fabien; Varin, Simon; Vaugeois, Florence; Vauthier, Jean-Charles; Vauthier, Virginie; Veillard, Delphine; Verjus, Anne-Laure; Verjus, Paul-Bernard; Verney, Gilles; Vialtel, Eloïse; Vierling, Fernand; Virgone-Rebaud, Graziella; Vital-Durand, Marc; Vittori, Eric; Volcler, Nadège; Vorilhon, Philippe; Watteau, Pierre; Weisbecker, Christine; Wey, Nathalie; Wilhelm-Nenot, Françoise; Wurtz, Jean-Louis; Yvon, Patricia; Zabawa, Claire; Zamboni, Jean-Marc; Zipper, Anne-Claire |
| Contributors: |
Modélisation et Évaluation des données complexes en Santé Publique (TIMC-MESP); Translational Innovation in Medicine and Complexity / Recherche Translationnelle et Innovation en Médecine et Complexité - UMR 5525 (TIMC); VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP); Université Grenoble Alpes (UGA)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP); Université Grenoble Alpes (UGA); Santé Ingénierie Biologie Saint-Etienne (SAINBIOSE); Centre Ingénierie et Santé (CIS-ENSMSE); École des Mines de Saint-Étienne (Mines Saint-Étienne MSE); Institut Mines-Télécom Paris (IMT)-Institut Mines-Télécom Paris (IMT)-École des Mines de Saint-Étienne (Mines Saint-Étienne MSE); Institut Mines-Télécom Paris (IMT)-Institut Mines-Télécom Paris (IMT)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM); Centre d'Investigation Clinique - Epidémiologie Clinique CHU Saint-Etienne (CIC-EC 1408); Centre Hospitalier Universitaire de Saint-Etienne CHU Saint-Etienne (CHU ST-E)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM); CHU de Grenoble-Alpes - Centre Hospitalier Universitaire CHU Grenoble (CHUGA); F-Crin INvestigation Network On Venous Thrombo-Embolism CHU Saint-Etienne (Innovte); Centre Hospitalier Universitaire de Saint-Etienne CHU Saint-Etienne (CHU ST-E); Procédés Alimentaires et Microbiologiques Dijon (PAM); Université de Bourgogne (UB)-Université Bourgogne Franche-Comté COMUE (UBFC)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut Agro Dijon; Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro); Aliment, Fermentation, Interaction, Microbiote (AFIM); Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Université de Bourgogne (UB)-Université Bourgogne Franche-Comté COMUE (UBFC)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut Agro Dijon; Antibioclic Paris, France; Université Paris Cité (UPCité); Université de Nantes (UN); Direction de la Recherche Clinique et de l’Innovation CHU Clermont-Ferrand (DRCI); CHU Clermont-Ferrand; Département de Médecine Générale Clermont-Ferrand; Faculté de Médecine - Clermont-Auvergne (FM - UCA); Université Clermont Auvergne 2017-2020 (UCA 2017-2020 )-Université Clermont Auvergne 2017-2020 (UCA 2017-2020 ); AutomédiCation aCcompagnement Pluriprofessionnel PatienT (ACCePPT); Université Clermont Auvergne 2017-2020 (UCA 2017-2020 ) |
| Source: |
ISSN: 0263-2136. |
| Publisher Information: |
CCSD; Oxford University Press (OUP): Policy B - Oxford Open Option D |
| Publication Year: |
2024 |
| Collection: |
Université Jean Monnet – Saint-Etienne: HAL |
| Subject Terms: |
[SDV]Life Sciences [q-bio] |
| Description: |
International audience ; Abstract Background The ability of bleeding risk scores to predict major bleeding (MB) or clinically relevant nonmajor bleeding (CRNMB) remains a topic of contention, particularly in nonselected patients in family practice. In addition, the capacity to predict bleeding risk using simple variables has yet to be established. Objectives The main objective was to confirm that severe anemia was the most predictive factor for the estimation of bleeding risk in patients treated with vitamin K antagonists (VKAs). Secondary objectives were to test the capacity of different bleeding scores to detect high-risk patients. Subsequently, the impact of functional decline on bleeding incidence was explored. Methods The CACAO study was a multicenter prospective cohort study of patients who, due to nonvalvular atrial fibrillation (NVAF) and/or venous thromboembolism (VTE), had been prescribed an oral anticoagulant by their general practitioner (GP) as a prophylactic measure. Patient characteristics were collected at the time of inclusion by GPs, who then monitored them in accordance with standard practice for one year. MB and CRNMB were the main outcomes for one year. By applying this approach, a total of 13 scores were analyzed. Results Aaemia was found to be strongly associated with MB (HR: 2.77, 95% CI: 1.2–6.36), with a particularly pronounced association observed in cases of severe anemia (HR: 12.9, 95% CI: 2.76–60.35). Twelve out of 27 MB cases were not identified by at least half of the scores. By contrast, functional decline was identified as a novel factor associated with MB (HR: 2.45, 95% CI: 1.13–5.31). Conclusions Preexisting anemia is a major prognostic factor associated with the occurrence of bleeding. It seems relevant to suggest that functional decline should be considered by GPs when assessing bleeding risk. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1093/fampra/cmae052 |
| Availability: |
https://uca.hal.science/hal-04958218; https://doi.org/10.1093/fampra/cmae052 |
| Accession Number: |
edsbas.82E762B |
| Database: |
BASE |