Predicting the risk of venous thromboembolism recurrence

John A. Heit

Research output: Contribution to journalArticle

60 Citations (Scopus)

Abstract

Venous thromboembolism (VTE) is a chronic disease with a 30% ten-year recurrence rate. The highest incidence of recurrence is in the first 6 months. Active cancer significantly increases the hazard of early recurrence, and the proportions of time on standard heparin with an APTT ≥ 0.2 anti-X a U/mL, and on warfarin with an INR ≥ 2.0, significantly reduce the hazard. The acute treatment duration does not affect recurrence risk after treatment is stopped. Independent predictors of late recurrence include increasing patient age and body mass index, leg paresis, active cancer and other persistent VTE risk factors, idiopathic VTE, antiphospholipid antibody syndrome, antithrombin, protein C or protein S deficiency, hyperhomocysteinemia and a persistently increased plasma fibrin D-dimer. A recommendation for secondary prophylaxis should be individualized based on the risk for recurrent VTE (especially fatal pulmonary embolism) and bleeding. The appropriateness of secondary prophylaxis should be continuously reevaluated, and the prophylaxis stopped if the benefit no longer exceeds the risk.

Original languageEnglish (US)
JournalAmerican Journal of Hematology
Volume87
Issue numberSUPPL. 1
DOIs
StatePublished - May 2012

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Venous Thromboembolism
Recurrence
Antithrombin Proteins
Protein S Deficiency
Hyperhomocysteinemia
International Normalized Ratio
Antiphospholipid Syndrome
Paresis
Warfarin
Protein C
Pulmonary Embolism
Heparin
Neoplasms
Leg
Body Mass Index
Chronic Disease
Hemorrhage
Incidence
Therapeutics

ASJC Scopus subject areas

  • Hematology

Cite this

Predicting the risk of venous thromboembolism recurrence. / Heit, John A.

In: American Journal of Hematology, Vol. 87, No. SUPPL. 1, 05.2012.

Research output: Contribution to journalArticle

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