High rate of unprovoked recurrent venous thrombosis is associated with high thrombin‐generating potential in a prospective cohort study
| Autor: | Roger Luddington, C. Baglin, Trevor Baglin, Martin Besser, A. van Hylckama Vlieg |
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| Rok vydání: | 2008 |
| Předmět: |
Adult
Male medicine.medical_specialty Thrombophilia Cohort Studies Fibrin Fibrinogen Degradation Products Predictive Value of Tests Recurrence Internal medicine medicine Humans Prospective Studies Prospective cohort study Aged Aged 80 and over Venous Thrombosis First episode business.industry Incidence Hazard ratio Thrombin Hematology Middle Aged medicine.disease Confidence interval Venous thrombosis Anesthesia Predictive value of tests Multivariate Analysis Cardiology Female business Cohort study |
| Zdroj: | Journal of Thrombosis and Haemostasis. 6:1720-1725 |
| ISSN: | 1538-7836 |
| Popis: | Summary. Objective: To determine the predictive value of measurement of parameters of thrombin generation for unprovoked recurrent venous thrombosis. Methods: Measurements were made of thrombin generation in a prospective cohort study of 188 patients with a first episode of venous thrombosis that was unprovoked, or provoked by a non-surgical trigger. Results: The endogenous thrombin potential (ETP) was the only parameter associated with unprovoked recurrent thrombosis in a multivariate model [hazard ratio (HR) 1.3 per 100 nmol L min−1 increase, 95% confidence interval (CI) 1.0–1.6]. Patients with a high ETP had a significantly higher rate of unprovoked recurrence than those with a low ETP (HR 2.9, 95% CI 1.3–6.6, cumulative recurrence at 4 years 27% vs. 11%). Patients with an unprovoked first event had a significantly higher rate of unprovoked recurrence than those with a provoking factor (HR 2.7, 95% CI 1.2–6.1), and in these patients there was a significantly higher rate of unprovoked recurrence in association with a high ETP (HR 4.0, 95% CI 1.3–11.8). After adjustment for D-dimer, thrombophilia, sex, and whether or not the first event was unprovoked, a high ETP remained a significant predictor of recurrence (HR 2.6, 95% CI 1.2–6.0). Conclusions: This study demonstrates a high rate of unprovoked recurrent venous thrombosis in patients presenting with a first episode of venous thrombosis and a high ETP. |
| Databáze: | OpenAIRE |
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