タカダ　タクマ   TAKADA Takuma   髙田　卓磨    所属   研究施設 研究施設    職種   非常勤講師
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Subclass phenotypes in patients with unprovoked venous thromboembolisms using a latent class analysis.
掲載誌名	正式名：Thrombosis research 略　 称：Thromb Res ISSNコード：18792472/00493848
掲載区分	国外
巻・号・頁	238,pp.27-36
著者・共著者	Ikeda Shinya, Yamashita Yugo, Morimoto Takeshi, Chatani Ryuki, Kaneda Kazuhisa, Nishimoto Yuji, Ikeda Nobutaka, Kobayashi Yohei, Ikeda Satoshi, Kim Kitae, Inoko Moriaki, Takase Toru, Tsuji Shuhei, Oi Maki, Takada Takuma, Otsui Kazunori, Sakamoto Jiro, Ogihara Yoshito, Inoue Takeshi, Usami Shunsuke, Chen Po-Min, Togi Kiyonori, Koitabashi Norimichi, Hiramori Seiichi, Doi Kosuke, Mabuchi Hiroshi, Tsuyuki Yoshiaki, Murata Koichiro, Takabayashi Kensuke, Nakai Hisato, Sueta Daisuke, Shioyama Wataru, Dohke Tomohiro, Nishikawa Ryusuke, Ono Koh, Kimura Takeshi
発行年月	2024/04
概要	BACKGROUND:Patients with unprovoked venous thromboembolisms (VTEs) can be sub-classified based on the different phenotypes using a latent class analysis (LCA), which might be useful for selecting individual management strategies.METHODS:In the COMMAND VTE Registry-2 database enrolling 5197 VTE patients, the current derivation cohort consisted of 1556 patients with unprovoked VTEs. We conducted clustering with an LCA, and the patients were classified into subgroups with the highest probability. We compared the clinical characteristics and outcomes among the developed subgroups.RESULTS:This LCA model proposed 3 subgroups based on 8 clinically relevant variables, and classified 592, 813, and 151 patients as Class I, II, and III, respectively. Based on the clinical features, we named Class I the younger, Class II the older with a few comorbidities, and Class III the older with many comorbidities. The cumulative 3-year anticoagulation discontinuation rate was highest in the older with many comorbidities (Class III) (39.9 %, 36.1 %, and 48.4 %, P = 0.02). There was no significant difference in the cumulative 5-year incidence of recurrent VTEs among the 3 classes (12.8 %, 11.1 %, and 4.0 % P = 0.20), whereas the cumulative 5-year incidence of major bleeding was significantly higher in the older with many comorbidities (Class III) (7.8 %, 12.7 %, and 17.8 %, P = 0.04).CONCLUSION:The current LCA revealed that patients with unprovoked VTEs could be sub-classified into further phenotypes depending on the patient characteristics. Each subclass phenotype could have different clinical outcomes risks especially a bleeding risk, which could have a potential benefit when considering the individual anticoagulation strategies.CLINICAL TRIAL REGISTRATION:URL: http://www.umin.ac.jp/ctr/index.htm COMMAND VTE Registry-2: Unique identifier, UMIN000044816 COMMAND VTE Registry: Unique identifier, UMIN000021132.
DOI	10.1016/j.thromres.2024.04.017
PMID	38653180