VTE Registry: What Can Be Learned from RIETE?

Inna Tzoran,Manuel Monreal,Benjamin Brenner,Manolis Papadakis,Pierpaolo Di Micco

doi:10.5041/rmmj.10171

Abstract

The Registro Informatizado de Enfermedad TromboEmbólica (RIETE Registry) is an ongoing, international, prospective registry of consecutive patients with acute venous thromboembolism (VTE) designed to gather and analyze data on treatment patterns and outcomes in patients with acute VTE. It started in Spain in 2001, and 6 years later the database was translated into English with the aim to expand the Registry to other countries. In contrast to randomized controlled trials, there is no imposed experimental intervention: the management is determined solely by physicians. Thus, it provides data on patients with VTE in a real-world situation with an unselected patient population. Data from RIETE are hypothesis-generating and provide feedback from real-world clinical situations. So far, we learned about the natural history of VTE in patients with relative or absolute contraindications to anticoagulant therapy. We also learned interesting aspects on the natural history of VTE, and we built a number of prognostic scores to identify VTE patients at low, moderate, or high risk for adverse outcome.

Highlights

Current guidelines on antithrombotic therapy provide a critical review of the literature related to the management of patients with venous thromboembolism (VTE) and lay the scientific groundwork for the standard of care, based largely on data from randomized controlled clinical trials.[1]
In a first article using the Registro Informatizado de Enfermedad TromboEmbólica (RIETE) database, we found that 26% of patients with VTE had at least one exclusion criterion to be recruited in randomized clinical trials of antithrombotic therapy
In a further study with 306 patients, we found that patients with recent gastrointestinal tract (GI) bleeding had an increased risk for both major rebleeding and death (HR 1.9; 95% CI 1.2–3.1) compared to those with no recent bleeding

Summary

INTRODUCTION

Current guidelines on antithrombotic therapy provide a critical review of the literature related to the management of patients with venous thromboembolism (VTE) and lay the scientific groundwork for the standard of care, based largely on data from randomized controlled clinical trials.[1]. In 2007, we built a clinical prediction rule to identify which cancer patients were at a higher risk for recurrent PE or major bleeding during the first 3 months of anticoagulation.[8] On multivariate analysis, patients aged

Limitations and Strengths

Findings

CONCLUSIONS AND FUTURE PERSPECTIVES