title: Risk factors associated with a thrombotic or bleeding event in patients treated with vitamin K antagonists.
abstract: OBJECTIVE
  To identify, in a case-control study, the risk factors associated with a thrombotic or bleeding event in patients treated with vitamin K antagonists.
  
  
  METHODS
  We performed a single-centre observational study during a three-month period where we consecutively included patients admitted to the emergency department of a secondary-level hospital and treated with vitamin K antagonists, regardless the reason for admission. Patients admitted for a thrombotic or bleeding event were included as cases and the other patients served as controls. Main thrombotic or bleeding risk factors during vitamin K antagonist therapy were a priori identified in literature and tested in conditional logistic regression.
  
  
  RESULTS
  Two hundred and forty subjects were identified, 40 of which (17%) were admitted for a bleeding event, 19 (8%) for a thrombotic event and 181 (75%) for another reason. Over 85% of patients were treated with fluindione. No risk factor was significantly associated with bleeding or thrombotic event in patients treated with vitamin K antagonist. Patients presenting a thrombotic event were however more likely to have a chronic respiratory disease.
  
  
  CONCLUSIONS
  In this study, no risk factor significantly associated with a bleeding or thrombotic event in patients treated with vitamin K antagonist were identified. The occurrence of these events supposes other risk factors, including potential genetic polymorphisms that should be considered in future studies.
authors.affiliation: Centre régional de pharmacovigilance, faculté de médecine, université Lille 2, centre hospitalier de Lille, 1, place de Verdun, 59045 Lille, France. Electronic address: johana.bene@chru-lille.fr.
authors.forename: J
authors.initials: J
authors.lastname: Béné
authors.affiliation: Service des urgences, centre hospitalier Germon-et-Gauthier, 62408 Béthune, France.
authors.forename: A-E
authors.initials: AE
authors.lastname: Dubart
authors.affiliation: Service pharmacie, centre hospitalier Germon-et-Gauthier, 62408 Béthune, France.
authors.forename: C
authors.initials: C
authors.lastname: Senis
authors.affiliation: Centre régional de pharmacovigilance, faculté de médecine, université Lille 2, centre hospitalier de Lille, 1, place de Verdun, 59045 Lille, France.
authors.forename: M
authors.initials: M
authors.lastname: Auffret
authors.affiliation: Centre régional de pharmacovigilance, faculté de médecine, université Lille 2, centre hospitalier de Lille, 1, place de Verdun, 59045 Lille, France.
authors.forename: J
authors.initials: J
authors.lastname: Caron
authors.affiliation: Centre régional de pharmacovigilance, faculté de médecine, université Lille 2, centre hospitalier de Lille, 1, place de Verdun, 59045 Lille, France.
authors.forename: S
authors.initials: S
authors.lastname: Gautier
mesh_terms: D000074:Acenocoumarol / Q000009:adverse effects / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D016022:Case-Control Studies; D004347:Drug Interactions; D004636:Emergency Service, Hospital; D005260:Female; D020022:Genetic Predisposition to Disease; D006470:Hemorrhage / Q000139:chemically induced / Q000453:epidemiology*; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D010630:Phenindione / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D012120:Respiration Disorders / Q000453:epidemiology; D012307:Risk Factors; D063728:Secondary Care Centers; D013927:Thrombosis / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control; D014812:Vitamin K / Q000037:antagonists & inhibitors*; D014859:Warfarin / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D014812:Vitamin K; D010630:Phenindione; D014859:Warfarin; C017673:fluindione; D000074:Acenocoumarol
keywords: Adverse drug events; Antivitamines K; Bleeding; Case-control study; Facteurs de risque; Hémorragies; Risk factors; Thromboses; Thrombosis; Vitamin K antagonists; Étude cas-témoin