Evidence map›Paper›PMID 35513826›Full record

ArticleThrombosis journal2022

LMWHs dosage and outcomes in acute pulmonary embolism with renal insufficiency, an analysis from a large real-world study.

Dingyi Wang, Guohui Fan, Jieping Lei, Yuanhua Yang, Xiaomao Xu, Yingqun Ji, Qun Yi, Hong Chen, Xiaoyun Hu, Zhihong Liu and 16 more

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Thrombosis journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02943343 (The China Pulmonary Thromboembolism Registry Study), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.5field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02943343 unknown statusnot on this map

The China Pulmonary Thromboembolism Registry Study (CURES)

Typeobservational_patient_registrySponsorChina-Japan Friendship HospitalRan2009 to 2025Enrolled15,000ConditionsPulmonary Embolism, Deep Venous Thrombosis, Venous ThromboembolismArmsNo intervention
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
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  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

26 authors at 11 institutions in 1 country.

Dingyi Wang *Institute of Clinical Medical Sciences, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.
Guohui Fan *Institute of Clinical Medical Sciences, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.
Jieping LeiInstitute of Clinical Medical Sciences, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.
Yuanhua YangDepartment of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Xiaomao XuDepartment of Pulmonary and Critical Care Medicine, Beijing Hospital, National Center of Gerontology, Beijing, China.
Yingqun JiDepartment of Pulmonary and Critical Care Medicine, East Hospital, Tongji University School of Medicine, Shanghai, China.
Qun YiDepartment of Pulmonary and Critical Care Medicine, Sichuan University West China Hospital, Chengdu, China.
Hong ChenDepartment of Pulmonary and Critical Care Medicine, Chongqing Medical University First Affiliated Hospital, Chongqing, China.
Xiaoyun HuFirst Hospital of Shanxi Medical University, First Hospital of Shanxi Medical University, Taiyuan, China.
Zhihong LiuDepartment of Cardiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Yimin MaoDepartment of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, China.
Jie ZhangDepartment of Pulmonary Critical Care Medicine, Jilin University Second Hospital, Changchun, China.
Juhong ShiDepartment of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Beijing, China.
Zhu ZhangInstitute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.
Sinan WuInstitute of Clinical Medical Sciences, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.
Xincao TaoInstitute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.
Wanmu XieInstitute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.
Jun WanDepartment of Pulmonary and Critical Care Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Yunxia ZhangInstitute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.
Shuai ZhangInstitute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.
Kaiyuan ZhenInstitute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.
Zhonghe ZhangDepartment of Pulmonary and Critical Care Medicine, First Affiliated Hospital of Dalian Medical University, Dalian, China.
Baomin FangInstitute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
Chen WangInstitute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China. wangchen@pumc.edu.cn.
Zhenguo ZhaiInstitute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China. zhaizhenguo2011@126.com.
China pUlmonary thromboembolism REgistry Study (CURES) investigators
Chinese Academy of Medical Sciences & Peking Union Medical College · CNChina-Japan Friendship Hospital · CNFirst Affiliated Hospital of Dalian Medical University · CNBeijing Anzhen Hospital · CNBeijing Chao-Yang Hospital · CNFirst Affiliated Hospital of Chongqing Medical University · CNFirst Affiliated Hospital of Henan University of Science and Technology · CNFirst Hospital of Shanxi Medical University · CNSecond Affiliated Hospital of Jilin University · CNShanghai East Hospital · CNSichuan University · CN

Funding

China-Japan Friendship Hospital Grant 2019-2-QN-78the CAMS Innovation Fund for Medical Sciences (CIFMS) 2018-I2M-1-003The Fundamental Research Funds for the Central Universities 3332021086the Fund of The National Key R&D Program of China 2018YFC1315100the Fund of The National Key R&D Program of China2016YFC0905600 2016YFC0905600
6 · The paper itself

Abstract

backgroundRenal function is associated with prognoses for acute pulmonary embolism (PE).

objectiveTo investigate the application of anticoagulants and dosage of LMWH among patients with renal insufficiency (RI), and the association between LWMH dosage and the patients' in-hospital outcomes.

methodsAdult patients diagnosed with non-high risk acute PE from 2009 to 2015, with available data of creatinine clearance (CCr) were enrolled from a multicenter registry in China. Renal insufficiency (RI) was defined as CCr < 60 ml/min. LMWH dosage was converted into IU/kg daily dose and presented as adjusted dose (≤ 100 IU/kg/day) and conventional dose (> 100 IU/kg/day). All-cause death, PE-related death and bleeding events during hospitalization were analyzed as endpoints.

resultsAmong the enrolled 5870 patients, RI occurred in 1311 (22.3%). 30 ≤ CCr < 60 ml/min was associated with higher rate of bleeding events and CCr < 30 ml/min was associated with all-cause death, PE-related death and major bleeding. Adjusted-dose LMWH was applied in 26.1% of patients with 30 ≤ CCr < 60 ml/min and in 26.2% of CCr < 30 ml/min patients. Among patients with RI, in-hospital bleeding occurred more frequently in those who were administered conventional dose of LMWH, compared with adjusted dose (9.2% vs 5.0%, p = 0.047). Adjusted dose of LMWH presented as protective factor for in-hospital bleeding (OR 0.62, 95%CI 0.27-1.00, p = 0.0496) and the risk of bleeding increased as length of hospital stay prolonged (OR 1.03, 95%CI 1.01-1.06, p = 0.0014).

conclusionsThe proportion of adjusted usage of LMWH was low. The application of adjusted-dose LMWH was associated with lower risk of in-hospital bleeding for RI patients, in real-world setting of PE treatment. Anticoagulation strategy for RI patients should be paid more attention and requires evidence of high quality.

trial registrationThe CURES was registered in ClinicalTrias.gov, identifier number: NCT02943343 .

Indexed as

Acute pulmonary embolismAdjusted dosageLow molecular weight heparinPrognosesRenal insufficiency

Identifiers

PMID35513826
PMCPMC9074331
OpenAlexW4229021995

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.