Index clinical manifestation of @entity1211 predicts early recurrence type and frequency: a meta-analysis of XXXX .

@entity1 @entity1151 @entity1150 @entity23 @entity1211
BACKGROUND: Observational studies suggest index clinical manifestation of @entity1211 ( @entity1211 ) predicts recurrence type. Data regarding the association between index manifestation and recurrence rates are conflicting. OBJECTIVES: To perform a meta-analysis of @entity23 ( @entity23 ) to determine the type and frequency of recurrent @entity1211 (rVTE) in @entity1 after an index @entity1150 ( @entity1150 ) or @entity1151 ( @entity1151 ). @entity1 /METHODS: We searched bibliographic databases for @entity23 of acute (early) treatment of rVTE in @entity1 with an index @entity1150 or @entity1151 (  @entity1150 ), enrolling >=   50 subjects anticoagulated >=   3-months and reporting types of rVTE. We pooled (random-effects) the proportion of rVTEs that were DVTs, PEs, and fatal PEs, the proportion of recurrent PEs that were fatal, and absolute rVTE rates. RESULTS: In nine @entity23 (N  =  13  640; 413 rVTEs) evaluating @entity1 with an index @entity1151 ; 66% (95% CI, 60-72%) of rVTEs were @entity1151 and 27% (95% CI, 22-33%) were fatal @entity1151 . Among 25 @entity23 (N  =  17  340; 692 rVTEs) evaluating @entity1 with an index @entity1150 , 36% (95% CI, 29-44%) experienced a recurrent @entity1151 and 10% (95% CI, 7-13%) a fatal @entity1151 . Recurrent PEs following an index @entity1151 had a higher fatality rate than after an index @entity1150 (41%; 95% CI, 33-48% vs. 25%; 95% CI, 18-33%; P  =  0.007). The rVTE rate was higher following an index @entity1150 compared with a @entity1151 (2.6%; 95% CI, 1.6-3.8% vs. 4.9%; 95% CI, 4.0-6.0%; P  =  0.002). CONCLUSIONS: Our meta-analysis suggests most rVTEs will be the same type as the index event. While index DVTs are associated with a higher rVTE rate than index PEs; recurrent PEs are associated with high fatality.
