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Age at first venous thromboembolism and risk of recurrence: a prospective cohort study.
Medicine (Baltimore) 2009; 88(6):366-70M

Abstract

Risk of first venous thromboembolism (VTE) increases with age. We investigated whether age is related to the risk of recurrent VTE. We followed 694 patients for a mean of 40 months after first unprovoked proximal deep vein thrombosis (DVT) and/or pulmonary embolism (PE) and withdrawal of anticoagulants. We excluded patients with natural inhibitor deficiency, lupus anticoagulant, or cancer; patients who required indefinite anticoagulation; pregnant women; and women who had VTE related to female hormone use. The endpoint was symptomatic recurrent VTE.VTE recurred in 152 patients (22%). The adjusted hazard ratio (HR) of recurrence for a 10-year increase in age was 0.94 (95% confidence interval [CI], 0.82-1.08; p = 0.4). Compared with patients aged younger than 47 years (1st tercile of patient population) no significant increase in the risk of recurrent VTE was found among patients 47-61 years old (2nd tercile) or patients older than 61 years (3rd tercile) ([HR, 1.25; 95% CI, 0.78-2.01] and [HR, 0.93l; 95% CI, 0.56-1.53], respectively). Compared to patients older than 80 years, the HR of recurrence among patients younger than 50 years was 1.11 (95% CI, 0.11-10.3; p = 0.9). After 5 years, probability of recurrence was 32% (95% CI, 24%-40%) among patients aged less than 47 years; 21% (95% CI, 15%-28%) among patients 47-61 years old; and 33% (95% CI, 24%-42%) among patients older than 61 years (p = 0.5).Our results show that in patients with first unprovoked proximal DVT and/or PE, risk of recurrence is not related to age at first VTE. Regardless of age, these patients have a high risk of recurrence.

Authors+Show Affiliations

Department of Medicine I, Medical University of Vienna, Währinger Gürtel 18-20, Vienna, Austria.No affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

19910751

Citation

Eischer, Lisbeth, et al. "Age at First Venous Thromboembolism and Risk of Recurrence: a Prospective Cohort Study." Medicine, vol. 88, no. 6, 2009, pp. 366-70.
Eischer L, Eichinger S, Kyrle PA. Age at first venous thromboembolism and risk of recurrence: a prospective cohort study. Medicine (Baltimore). 2009;88(6):366-70.
Eischer, L., Eichinger, S., & Kyrle, P. A. (2009). Age at first venous thromboembolism and risk of recurrence: a prospective cohort study. Medicine, 88(6), pp. 366-70. doi:10.1097/MD.0b013e3181c29e31.
Eischer L, Eichinger S, Kyrle PA. Age at First Venous Thromboembolism and Risk of Recurrence: a Prospective Cohort Study. Medicine (Baltimore). 2009;88(6):366-70. PubMed PMID: 19910751.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Age at first venous thromboembolism and risk of recurrence: a prospective cohort study. AU - Eischer,Lisbeth, AU - Eichinger,Sabine, AU - Kyrle,Paul A, PY - 2009/11/14/entrez PY - 2009/11/17/pubmed PY - 2009/12/16/medline SP - 366 EP - 70 JF - Medicine JO - Medicine (Baltimore) VL - 88 IS - 6 N2 - Risk of first venous thromboembolism (VTE) increases with age. We investigated whether age is related to the risk of recurrent VTE. We followed 694 patients for a mean of 40 months after first unprovoked proximal deep vein thrombosis (DVT) and/or pulmonary embolism (PE) and withdrawal of anticoagulants. We excluded patients with natural inhibitor deficiency, lupus anticoagulant, or cancer; patients who required indefinite anticoagulation; pregnant women; and women who had VTE related to female hormone use. The endpoint was symptomatic recurrent VTE.VTE recurred in 152 patients (22%). The adjusted hazard ratio (HR) of recurrence for a 10-year increase in age was 0.94 (95% confidence interval [CI], 0.82-1.08; p = 0.4). Compared with patients aged younger than 47 years (1st tercile of patient population) no significant increase in the risk of recurrent VTE was found among patients 47-61 years old (2nd tercile) or patients older than 61 years (3rd tercile) ([HR, 1.25; 95% CI, 0.78-2.01] and [HR, 0.93l; 95% CI, 0.56-1.53], respectively). Compared to patients older than 80 years, the HR of recurrence among patients younger than 50 years was 1.11 (95% CI, 0.11-10.3; p = 0.9). After 5 years, probability of recurrence was 32% (95% CI, 24%-40%) among patients aged less than 47 years; 21% (95% CI, 15%-28%) among patients 47-61 years old; and 33% (95% CI, 24%-42%) among patients older than 61 years (p = 0.5).Our results show that in patients with first unprovoked proximal DVT and/or PE, risk of recurrence is not related to age at first VTE. Regardless of age, these patients have a high risk of recurrence. SN - 1536-5964 UR - https://www.unboundmedicine.com/medline/citation/19910751/Age_at_first_venous_thromboembolism_and_risk_of_recurrence:_a_prospective_cohort_study_ L2 - http://Insights.ovid.com/pubmed?pmid=19910751 DB - PRIME DP - Unbound Medicine ER -