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Venous thromboembolism: risk factors for recurrence.
Arterioscler Thromb Vasc Biol 2009; 29(3):298-310AT

Abstract

Patients who have a first episode of venous thromboembolism (VTE) have an elevated risk of a recurrent episode, and this necessitates secondary prophylaxis. Anticoagulant therapy is a double-edged sword, however, as it reduces the risk of recurrent VTE but increases the risk of hemorrhage. This balance must be taken into account when assessing the risk-benefit ratio of long-term anticoagulation. Some clinical characteristics of the index VTE event can help to categorize the individual risk of recurrence. Patients with persistent risk factors such as cancer have a significantly higher risk of recurrent thrombosis. In contrast, VTE provoked by transient risk factors is associated with a lower risk of recurrence. Intrinsic features of patients with VTE (gender, age, hereditary thrombophilia) have also been linked to the risk of recurrent VTE. There is increasing evidence that a normal D-dimer level and the absence of residual venous thrombosis after discontinuation of oral anticoagulation are associated with a lower risk of recurrent VTE events. Future studies are needed to refine the predictive value of known risk factors for VTE recurrence and to discover better markers.

Authors+Show Affiliations

University Paris Descartes, Inserm U765, Service de Médecine Vasculaire-HTA, Paris, France.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

19228602

Citation

Zhu, Tienan, et al. "Venous Thromboembolism: Risk Factors for Recurrence." Arteriosclerosis, Thrombosis, and Vascular Biology, vol. 29, no. 3, 2009, pp. 298-310.
Zhu T, Martinez I, Emmerich J. Venous thromboembolism: risk factors for recurrence. Arterioscler Thromb Vasc Biol. 2009;29(3):298-310.
Zhu, T., Martinez, I., & Emmerich, J. (2009). Venous thromboembolism: risk factors for recurrence. Arteriosclerosis, Thrombosis, and Vascular Biology, 29(3), pp. 298-310. doi:10.1161/ATVBAHA.108.182428.
Zhu T, Martinez I, Emmerich J. Venous Thromboembolism: Risk Factors for Recurrence. Arterioscler Thromb Vasc Biol. 2009;29(3):298-310. PubMed PMID: 19228602.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Venous thromboembolism: risk factors for recurrence. AU - Zhu,Tienan, AU - Martinez,Isabelle, AU - Emmerich,Joseph, PY - 2009/2/21/entrez PY - 2009/2/21/pubmed PY - 2009/3/6/medline SP - 298 EP - 310 JF - Arteriosclerosis, thrombosis, and vascular biology JO - Arterioscler. Thromb. Vasc. Biol. VL - 29 IS - 3 N2 - Patients who have a first episode of venous thromboembolism (VTE) have an elevated risk of a recurrent episode, and this necessitates secondary prophylaxis. Anticoagulant therapy is a double-edged sword, however, as it reduces the risk of recurrent VTE but increases the risk of hemorrhage. This balance must be taken into account when assessing the risk-benefit ratio of long-term anticoagulation. Some clinical characteristics of the index VTE event can help to categorize the individual risk of recurrence. Patients with persistent risk factors such as cancer have a significantly higher risk of recurrent thrombosis. In contrast, VTE provoked by transient risk factors is associated with a lower risk of recurrence. Intrinsic features of patients with VTE (gender, age, hereditary thrombophilia) have also been linked to the risk of recurrent VTE. There is increasing evidence that a normal D-dimer level and the absence of residual venous thrombosis after discontinuation of oral anticoagulation are associated with a lower risk of recurrent VTE events. Future studies are needed to refine the predictive value of known risk factors for VTE recurrence and to discover better markers. SN - 1524-4636 UR - https://www.unboundmedicine.com/medline/citation/19228602/Venous_thromboembolism:_risk_factors_for_recurrence_ L2 - http://www.ahajournals.org/doi/full/10.1161/ATVBAHA.108.182428?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -