Thrombophilic abnormalities and recurrence of venous thromboembolism in patients treated with standardized anticoagulant treatment
| Autor: | Cristina Tomasi, Giuliana Guazzaloca, Adriano Bertoldi, Mario Bazzan, Marco Moia, Mauro Silingardi, Maria Gabriella Santamaria, Walter Ageno, Paolo Prandoni, Giancarlo Agnelli, Maria Rita Taliani, Giovan Battista Ambrosio |
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| Rok vydání: | 2004 |
| Předmět: |
Male
medicine.medical_specialty Deep vein Thrombophilia Gastroenterology Protein C deficiency Recurrence Internal medicine Thromboembolism medicine Coagulopathy Prevalence Humans Genetic Predisposition to Disease Aged Retrospective Studies First episode Venous Thrombosis biology business.industry Incidence Factor V Anticoagulants Hematology Middle Aged medicine.disease Surgery Pulmonary embolism Venous thrombosis medicine.anatomical_structure biology.protein Female business |
| Zdroj: | Thrombosis research. 116(4) |
| ISSN: | 0049-3848 |
| Popis: | Introduction Whether patients with hereditary or acquired thrombophilia have an increased risk for recurrence of venous thromboembolism (deep vein thrombosis and/or pulmonary embolism) is still controversial. The aim of this study was to evaluate the incidence of recurrence of venous thromboembolism in patients with and without thrombophilic abnormalities treated with standardized anticoagulant treatment. Material and methods Database was from a prospective multicenter randomized study aimed at evaluating the long-term clinical benefit of extending to 1 year the 3-month oral anticoagulant treatment after a first episode of idiopathic proximal deep vein thrombosis. The screening for thrombophilia included antithrombin, protein C, protein S deficiencies, resistance to activated protein C and/or factor V R506Q mutation, the mutation 20210GA of the prothrombin gene, hyperhomocysteinemia and antiphospholipid antibodies. The diagnosis of venous thromboembolism recurrence was done by objective tests and adjudicated by a panel unaware of the results of the thrombophilia screening. Results A screening for thrombophilic abnormalities was performed in 195 patients. Twenty of 57 (35.1%) thrombophilic patients experienced a recurrence of venous thromboembolism as compared with 29 of 138 (21.0%) patients without thrombophilia (HR=1.78, 95% CI 1.002–3.140, p =0.046). The difference in VTE recurrence between patients with and without thrombophilia was accounted for by those who received 3 months of oral anticoagulation (HR=3.21, 95% CI 1.349–7.616, p =0.008). No difference between thrombophilic and non-thrombophilic patients was observed in the time interval from the index episode to recurrent venous thromboembolism (29.1±23.9 and 30.6±19.8 months, respectively). Conclusions Thrombophilic abnormalities are associated with an increased risk of venous thromboembolism recurrence. The role of thrombophilia in the long-term management of venous thromboembolism should be addressed in prospective management studies. |
| Databáze: | OpenAIRE |
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