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Title

Patients with a first symptomatic unprovoked deep vein thrombosis are at higher risk of recurrent venous thromboembolism than patients with a first unprovoked pulmonary embolism

Authors
Kovacs, M. J.
Kahn, S. R.
Wells, P. S.
Anderson, D. A.
G, L. E. Gal
Solymoss, S.
Crowther, M.
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Published in Journal of Thrombosis and Haemostasis. 2010, vol. 8, no. 9, p. 1926-1932
Abstract BACKGROUND: Previous studies are mixed as to whether patients with unprovoked pulmonary embolism (PE) have a higher rate of venous thromboembolism (VTE) recurrence after anticoagulation is discontinued than patients with unprovoked deep vein thrombosis (DVT). OBJECTIVES: To determine whether patients with unprovoked PE have a higher rate of VTE recurrence than patients with unprovoked DVT in a prospective multicenter cohort study. PATIENTS/METHODS: Six hundred and forty-six patients with a first episode of symptomatic unprovoked VTE were treated with heparin and subsequent oral anticoagulation for 5-7 months, and were followed every 6 months for recurrent VTE after their anticoagulant therapy was discontinued. RESULTS: Of 646 patients, 194 had isolated PE, 339 had isolated DVT, and 113 had both DVT and PE. After a mean of 18 months of follow-up, there were 91 recurrent VTE events (9.5% annualized risk of recurrent VTE in the total population). The crude recurrent VTE rate for the isolated PE, isolated DVT and DVT and PE groups were 7.7%, 16.5% and 17.7%, respectively. The relative risk of recurrent VTE for isolated DVT vs. isolated PE was 2.1 (95% confidence interval 1.2-3.7). CONCLUSIONS: This study has demonstrated that patients with a first episode of unprovoked isolated DVT are 2.1 times more likely to have a recurrent VTE episode than patients with a first episode of unprovoked isolated PE. These findings need to be considered when determining the optimal duration of anticoagulant therapy for patients with unprovoked VTE.
Keywords Administration, OralAgedAnticoagulants/therapeutic useCohort StudiesFemaleFollow-Up StudiesHumansMaleMiddle AgedProspective StudiesPulmonary Embolism/complications/*diagnosisRecurrenceRiskTreatment OutcomeVenous Thromboembolism/complications/*diagnosisVenous Thrombosis/*complications/*therapy
Identifiers
PMID: 20561184
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Structures
Research groups Groupe Perrier Arnaud (Médecine interne générale, de réhabilitation et de gériatrie) (585)
La maladie thromboembolique veineuse (808)
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(ISO format)
KOVACS, M. J. et al. Patients with a first symptomatic unprovoked deep vein thrombosis are at higher risk of recurrent venous thromboembolism than patients with a first unprovoked pulmonary embolism. In: Journal of Thrombosis and Haemostasis, 2010, vol. 8, n° 9, p. 1926-1932. https://archive-ouverte.unige.ch/unige:21052

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Deposited on : 2012-05-23

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