Subscribe to RSS
DOI: 10.1160/TH17-07-0511
Rationale, Design and Methodology of the Computerized Registry of Patients with Venous Thromboembolism (RIETE)
Publication History
25 July 2017
15 September 2017
Publication Date:
05 January 2018 (online)
Abstract
Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is a preventable cause of in-hospital death, and one of the most prevalent vascular diseases. There is a lack of knowledge with regards to contemporary presentation, management and outcomes of patients with VTE. Many clinically important subgroups (including the elderly, those with recent bleeding and pregnant patients) have been under-represented in clinical trials. Furthermore, design of clinical trials is challenging in some scenarios, such as in those with hemodynamically unstable PE. RIETE (Registro Informatizado Enfermedad TromboEmbolica) is a large prospective multinational ongoing registry, designed to address these unmet needs using representative data from multiple centres. Initiated in Spain in 2001, RIETE currently includes 179 centres in 24 countries and has enrolled more than 72,000 patients. RIETE has helped characterize the pattern of presentation and outcomes of VTE, including the aforementioned understudied subgroups. RIETE has recently expanded to collect long-term outcome data, and has broadened its inclusion criteria to enrol other forms of venous thrombosis (such as cerebral vein thrombosis and splanchnic vein thrombosis). The RIETE platform is also being used to conduct pragmatic comparative effectiveness studies, including randomized trials. Future steps would focus on collaboration with additional centres across the world, and efforts to ensure the quality and expansion of the registry. In conclusion, RIETE is a large ongoing registry of patients with VTE and other thrombotic conditions. Its results could be helpful for improving our understanding of the epidemiology, patterns of care and outcomes of patients with thrombotic disease.
Source of Funding and Its Roles
RIETE is an investigator-initiated registry. During the first 5 years, it was supported by Red Respira from the Instituto Carlos III, Spain (Red Respira-ISCiii-RTIC-03/11).[13] It has been also supported by Sanofi Spain in Spain and by Bayer Pharma AG for the rest of the world. There is no payment per recruited patient. The main incentive for patients and investigators participating in RIETE is to generate new knowledge to help for better understanding of VTE epidemiology and outcomes. None of the sponsors have had any role in the design of the registry and do not have rights to access the database, or to review or comment on pre-published studies from RIETE.
-
References
- 1 Wendelboe AM, Raskob GE. Global burden of thrombosis: epidemiologic aspects. Circ Res 2016; 118 (09) 1340-1347
- 2 Geerts WH, Bergqvist D, Pineo GF. , et al. Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 2008; 133: 381S-453S
- 3 Bikdeli B, Sharif-Kashani B. Prophylaxis for venous thromboembolism: a great global divide between expert guidelines and clinical practice?. Semin Thromb Hemost 2012; 38 (02) 144-155
- 4 Heit JA, Cohen AT, Anderson FJ. Estimated annual number of incident and recurrent, non-fatal and fatal venous thromboembolism (VTE) events in the US. Blood 2005; 106: 267A
- 5 Cohen AT, Agnelli G, Anderson FA. , et al; VTE Impact Assessment Group in Europe (VITAE). Venous thromboembolism (VTE) in Europe. The number of VTE events and associated morbidity and mortality. Thromb Haemost 2007; 98 (04) 756-764
- 6 Bikdeli B, Bikdeli B. Updates on advanced therapies for acute pulmonary embolism. Int J Cardiovasc Pract 2016;1(3)
- 7 Kearon C, Akl EA, Comerota AJ. , et al. Antithrombotic therapy for VTE disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012; 141: e419S-e496S
- 8 Jaff MR, McMurtry MS, Archer SL. , et al; American Heart Association Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation; American Heart Association Council on Peripheral Vascular Disease; American Heart Association Council on Arteriosclerosis, Thrombosis and Vascular Biology. Management of massive and submassive pulmonary embolism, iliofemoral deep vein thrombosis, and chronic thromboembolic pulmonary hypertension: a scientific statement from the American Heart Association. Circulation 2011; 123 (16) 1788-1830
- 9 Stein PD, Henry JW. Clinical characteristics of patients with acute pulmonary embolism stratified according to their presenting syndromes. Chest 1997; 112 (04) 974-979
- 10 Goldhaber SZ, Visani L, De Rosa M. Acute pulmonary embolism: clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER). Lancet 1999; 353 (9162): 1386-1389
- 11 Minges KE, Bikdeli B, Wang Y. , et al. National trends in pulmonary embolism hospitalization rates and outcomes for adults aged ≥65 years in the United States (1999 to 2010). Am J Cardiol 2015; 116 (09) 1436-1442
- 12 Park B, Messina L, Dargon P, Huang W, Ciocca R, Anderson FA. Recent trends in clinical outcomes and resource utilization for pulmonary embolism in the United States: findings from the nationwide inpatient sample. Chest 2009; 136 (04) 983-990
- 13 Tzoran I, Brenner B, Papadakis M, Di Micco P, Monreal M. VTE Registry: What can be learned from RIETE?. Rambam Maimonides Med J 2014; 5 (04) e0037
- 14 Sherman RE, Anderson SA, Dal Pan GJ. , et al. Real-world evidence - What is it and what can it tell us?. N Engl J Med 2016; 375 (23) 2293-2297
- 15 Gitt AK, Bueno H, Danchin N. , et al. The role of cardiac registries in evidence-based medicine. Eur Heart J 2010; 31 (05) 525-529
- 16 Bhatt DL, Drozda Jr JP, Shahian DM. , et al. ACC/AHA/STS statement on the future of registries and the performance measurement enterprise: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures and The Society of Thoracic Surgeons. J Am Coll Cardiol 2015; 66 (20) 2230-2245
- 17 Bufalino VJ, Masoudi FA, Stranne SK. , et al; American Heart Association Advocacy Coordinating Committee. The American Heart Association's recommendations for expanding the applications of existing and future clinical registries: a policy statement from the American Heart Association. Circulation 2011; 123 (19) 2167-2179
- 18 Monreal M, Mahé I, Bura-Riviere A. , et al. Pulmonary embolism: epidemiology and registries. Presse Med 2015; 44 (12, Pt 2): e377-e383
- 19 Laporte S, Mismetti P, Décousus H. , et al; RIETE Investigators. Clinical predictors for fatal pulmonary embolism in 15,520 patients with venous thromboembolism: findings from the Registro Informatizado de la Enfermedad TromboEmbolica venosa (RIETE) Registry. Circulation 2008; 117 (13) 1711-1716
- 20 Lecumberri R, Soler S, Del Toro J. , et al; RIETE Investigators. Effect of the time of diagnosis on outcome in patients with acute venous thromboembolism. Findings from the RIETE Registry. Thromb Haemost 2011; 105 (01) 45-51
- 21 Jiménez D, de Miguel-Díez J, Guijarro R. , et al; RIETE Investigators. Trends in the management and outcomes of acute pulmonary embolism: analysis from the RIETE Registry. J Am Coll Cardiol 2016; 67 (02) 162-170
- 22 Morillo R, Jiménez D, Aibar MA. , et al; RIETE Investigators. DVT management and outcome trends, 2001 to 2014. Chest 2016; 150 (02) 374-383
- 23 Riera-Mestre A, Jiménez D, Muriel A. , et al; RIETE Investigators. Thrombolytic therapy and outcome of patients with an acute symptomatic pulmonary embolism. J Thromb Haemost 2012; 10 (05) 751-759
- 24 Jiménez D, Muriel A, Monreal M, Yusen RD. Reply: immortal time bias and the use of IVC filters. J Am Coll Cardiol 2014; 64 (09) 955-956
- 25 López-Jiménez L, Montero M, González-Fajardo JA. , et al; RIETE Investigators. Venous thromboembolism in very elderly patients: findings from a prospective registry (RIETE). Haematologica 2006; 91 (08) 1046-1051
- 26 Blanco-Molina A, Rota LL, Di Micco P. , et al; RIETE Investigators. Venous thromboembolism during pregnancy, postpartum or during contraceptive use. Thromb Haemost 2010; 103 (02) 306-311
- 27 Lobo JL, Nieto JA, Zorrilla V. , et al; RIETE Investigators. Venous thromboembolism in patients with intracranial haemorrhage. Thromb Haemost 2011; 106 (04) 750-752
- 28 Guijarro R, Montes J, Sanromán C, Monreal M. ; RIETE Investigators. Venous thromboembolism in Spain. Comparison between an administrative database and the RIETE registry. Eur J Intern Med 2008; 19 (06) 443-446
- 29 Jiménez D, Aujesky D, Moores L. , et al; RIETE Investigators. Simplification of the pulmonary embolism severity index for prognostication in patients with acute symptomatic pulmonary embolism. Arch Intern Med 2010; 170 (15) 1383-1389
- 30 Trujillo-Santos J, Schellong S, Falga C. , et al; RIETE Investigators. Low-molecular-weight or unfractionated heparin in venous thromboembolism: the influence of renal function. Am J Med 2013; 126 (05) 425-434.e1
- 31 Mellado M, Pijoan JI, Jiménez D. , et al; RIETE Investigators. Outcomes associated with inferior vena cava filters among patients with thromboembolic recurrence during anticoagulant therapy. JACC Cardiovasc Interv 2016; 9 (23) 2440-2448
- 32 Nieto JA, De Tuesta AD, Marchena PJ. , et al; RIETE Investigators. Clinical outcome of patients with venous thromboembolism and recent major bleeding: findings from a prospective registry (RIETE). J Thromb Haemost 2005; 3 (04) 703-709
- 33 Barba R, Marco J, Martín-Alvarez H. , et al; RIETE Investigators. The influence of extreme body weight on clinical outcome of patients with venous thromboembolism: findings from a prospective registry (RIETE). J Thromb Haemost 2005; 3 (05) 856-862
- 34 Mahé I, Chidiac J, Bertoletti L. , et al; RIETE Investigators. The clinical course of venous thromboembolism may differ according to cancer site. Am J Med 2017; 130 (03) 337-347
- 35 Muriel A, Jiménez D, Aujesky D. , et al; RIETE Investigators. Survival effects of inferior vena cava filter in patients with acute symptomatic venous thromboembolism and a significant bleeding risk. J Am Coll Cardiol 2014; 63 (16) 1675-1683
- 36 Agnelli G, Verso M, Ageno W. , et al; MASTER Investigators. The MASTER registry on venous thromboembolism: description of the study cohort. Thromb Res 2008; 121 (05) 605-610
- 37 Pollack CV, Schreiber D, Goldhaber SZ. , et al. Clinical characteristics, management, and outcomes of patients diagnosed with acute pulmonary embolism in the emergency department: initial report of EMPEROR (Multicenter Emergency Medicine Pulmonary Embolism in the Real World Registry). J Am Coll Cardiol 2011; 57 (06) 700-706
- 38 Casazza F, Becattini C, Bongarzoni A. , et al. Clinical features and short term outcomes of patients with acute pulmonary embolism. The Italian Pulmonary Embolism Registry (IPER). Thromb Res 2012; 130 (06) 847-852
- 39 Spirk D, Husmann M, Hayoz D. , et al. Predictors of in-hospital mortality in elderly patients with acute venous thrombo-embolism: the SWIss Venous ThromboEmbolism Registry (SWIVTER). Eur Heart J 2012; 33 (07) 921-926
- 40 Frank B, Ariza L, Lamparter H. , et al; VTEval study group. Rationale and design of three observational, prospective cohort studies including biobanking to evaluate and improve diagnostics, management strategies and risk stratification in venous thromboembolism: the VTEval Project. BMJ Open 2015; 5 (07) e008157
- 41 Agnelli G, Gitt AK, Bauersachs R. , et al; PREFER in VTE Investigators. The management of acute venous thromboembolism in clinical practice - study rationale and protocol of the European PREFER in VTE Registry. Thromb J 2015; 13: 41
- 42 Weitz JI, Haas S, Ageno W. , et al. Global Anticoagulant Registry in the Field - Venous Thromboembolism (GARFIELD-VTE). Rationale and design. Thromb Haemost 2016; 116 (06) 1172-1179
- 43 Lauer MS, D'Agostino Sr RB. The randomized registry trial--the next disruptive technology in clinical research?. N Engl J Med 2013; 369 (17) 1579-1581
- 44 The AINEP trial: EudraCT Public Web site. Available at: https://eudract.ema.europa.eu/ . Accessed July 5, 2017
- 45 The Slice Trials (NCT02238639). Available at: https://clinicaltrials.gov . Accessed July 5, 2017
- 46 The IPEP Trial. Available at: https://clinicaltrials.gov/ct2/show/NCT02733198 . Accessed September 1, 2017