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Thrombophilic abnormalities and recurrence of venous thromboembolism in patients treated with standardized anticoagulant treatment.
Thromb Res 2005; 116(4):301-6TR

Abstract

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.

Authors+Show Affiliations

Sezione di Medicina Interna e Cardiovascolare, Dipartimento di Medicina Interna, Università di Perugia, Via Enrico Dal Pozzo, 06123 Perugia, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16038714

Citation

Santamaria, Maria Gabriella, et al. "Thrombophilic Abnormalities and Recurrence of Venous Thromboembolism in Patients Treated With Standardized Anticoagulant Treatment." Thrombosis Research, vol. 116, no. 4, 2005, pp. 301-6.
Santamaria MG, Agnelli G, Taliani MR, et al. Thrombophilic abnormalities and recurrence of venous thromboembolism in patients treated with standardized anticoagulant treatment. Thromb Res. 2005;116(4):301-6.
Santamaria, M. G., Agnelli, G., Taliani, M. R., Prandoni, P., Moia, M., Bazzan, M., ... Ambrosio, G. B. (2005). Thrombophilic abnormalities and recurrence of venous thromboembolism in patients treated with standardized anticoagulant treatment. Thrombosis Research, 116(4), pp. 301-6.
Santamaria MG, et al. Thrombophilic Abnormalities and Recurrence of Venous Thromboembolism in Patients Treated With Standardized Anticoagulant Treatment. Thromb Res. 2005;116(4):301-6. PubMed PMID: 16038714.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Thrombophilic abnormalities and recurrence of venous thromboembolism in patients treated with standardized anticoagulant treatment. AU - Santamaria,Maria Gabriella, AU - Agnelli,Giancarlo, AU - Taliani,Maria Rita, AU - Prandoni,Paolo, AU - Moia,Marco, AU - Bazzan,Mario, AU - Guazzaloca,Giuliana, AU - Ageno,Walter, AU - Bertoldi,Adriano, AU - Silingardi,Mauro, AU - Tomasi,Cristina, AU - Ambrosio,Giovan Battista, AU - ,, Y1 - 2005/01/26/ PY - 2004/09/01/received PY - 2004/12/17/revised PY - 2004/12/19/accepted PY - 2005/7/26/pubmed PY - 2005/10/19/medline PY - 2005/7/26/entrez SP - 301 EP - 6 JF - Thrombosis research JO - Thromb. Res. VL - 116 IS - 4 N2 - 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. SN - 0049-3848 UR - https://www.unboundmedicine.com/medline/citation/16038714/Thrombophilic_abnormalities_and_recurrence_of_venous_thromboembolism_in_patients_treated_with_standardized_anticoagulant_treatment_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0049-3848(04)00655-3 DB - PRIME DP - Unbound Medicine ER -