Patterns of presentation of suspected and confirmed recurrent venous thromboembolism in patients with prior venous thromboembolism

Background : Patients with prior venous thromboembolism (VTE) seem to recur more frequently at the same site as their prior VTE, but their symptoms at presentation of suspected recurrent VTE is unclear.

Objectives : The aim was to describe the patterns of presentation of suspected and confirmed recurrent VTE.

Methods : This is a secondary analysis of the PREDICTORS study (ClinicalTrials.gov: NCT02297373), an international prospective multicenter observational cohort study. The primary outcomes were the location of symptoms and confirmed diagnosis of suspected recurrent VTE.

Results : In total, 708 patients were included. Patients with isolated deep venous thrombosis (DVT) as the most recent prior VTE presenting with suspected recurrent VTE had more frequently lower extremity symptoms only (249/343; 73%), rather than respiratory symptoms only (41/343; 12%), and confirmed recurrent VTE were mostly isolated proximal DVT (78/100; 78%). Patients with isolated pulmonary embolism as the most recent prior VTE presented more frequently with respiratory symptoms only (136/237; 56%), rather than lower extremity symptoms only (42/237; 18%), and confirmed recurrent VTE were more frequently isolated pulmonary embolism (38/62; 61%). Among patients with DVT as the most recent prior VTE, confirmed recurrent DVT were more frequently in the ipsilateral leg of the index event (ipsilateral 72/468 [15%], contralateral 31/468 [7%]; odds ratio 2.3 [95% CI, 1.5-3.6]).

Conclusion : In addition to confirming that patients were more frequently diagnosed with recurrent VTE at the same site of their last VTE, our study reported on suspected recurrent VTE symptoms and showed that patients presented more frequently with symptoms related to the same site of their last VTE.