Background:
The risk of recurrent venous thromboembolism (VTE) is high.
Aims:
To evaluate associated factors with recurrence intra-treatment and one-year after stopping anticoagulation.
Methods: Prospective cohort which included all consecutive patients with a first episode of deep vein thrombosis, included in the Institutional Registry from 1/6/2015 to 30/3/2019, who started anticoagulant treatment. We excluded patients with cancer or having a permanent IVF implantation or informed consent refusal. All patients were evaluated at 30 days pre-suspension of anticoagulation for d-dimer (DD) and ultrasound; at one-year after stopping anticoagulant with ultrasound and thrombophilia evaluation (if they were under 55 years or had no known risk factors for VTE). Outcomes were defined as recurrence (progression or new symptomatic event considered only during anticoagulation and once anticoagulation was suspended), bleeding (major and minor) and death.
Results: We included 304 patients, 73% were female and the median age was 80 years. The highest comorbidities were hypertension (61%) and dyslipidemia (35%). Risk factors for VTE: thrombophilia (5%), immobilization (3%) and trauma/surgery (2%). All patients received anticoagulation at the time of the event. The most frequent treatments were acenocoumarol and enoxaparin. The recurrence rate was 5% (n=16, 95%CI 3-8%) during anticoagulation and 4% (n=11, 95%CI 2-6%) after suspension. The overall bleeding rate was 13% (n=39, 95%CI 9-17%), and major bleeding 5%. Regarding associated factors with VTE recurrence, these patients presented higher baseline DD (age adjusted ratio), neutrophils and monocytes, more echographic whole leg affectation and shorter anticoagulation duration, without statistical significance.
Conclusions: In non oncology-patients, even when some parameters were elevated in the patients with VTE recurrence, these differences were not significant, probably because of the small sample size, the low recurrence rate, and the short follow-up period after anticoagulation suspension.
To cite this abstract in AMA style:
Posadas-Martinez ML, Torres Gómez F, Juana C, Grande Ratti MF, Burgos M, Mezzarobba D, Schutz N, Ruberto J, Dovasio MF, Martinuzzo M, Gonzalez Bernaldo De Quiros F, Vazquez FJ, Giunta DH. Predictors of Recurrence of Venous Thromboembolic Disease after Suspension of Anticoagulation [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/predictors-of-recurrence-of-venous-thromboembolic-disease-after-suspension-of-anticoagulation/. Accessed September 27, 2023.« Back to ISTH 2021 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/predictors-of-recurrence-of-venous-thromboembolic-disease-after-suspension-of-anticoagulation/