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Recurrence and Mortality Following First Venous Thromboembolism among Saudi Population: Single-centre Cohort Study

F. Aleidan1, R. Almanea1, N. Shalash1, N. Alrajhi1, A. Almoneef1, S. Almousa1, K. Abuelgasim1

1King Abdulaziz Medical City, Riyadh, Saudi Arabia

Abstract Number: PB1199

Meeting: ISTH 2021 Congress

Theme: Venous Thromboembolism » VTE Epidemiology

Background: Little is written about recurrence and mortality rates after a first episode of venous thromboembolism (VTE) among Saudi population.

Aims: To estimate the incidence rates and assess the risk factors associated with recurrence and mortality after a first VTE events.

Methods: We retrospectively followed up 1124 patients aged ≥18 years with a symptomatic VTE confirmed by imaging test.  In this single-centre Saudi cohort study, the incidence of VTE recurrence and mortality were assessed. The association between characteristics of patients and VTE recurrence and mortality were explored by estimating hazard ratio (HR) and 95% confidence interval (CI) using univariate and multivariate cox regression. Furthermore, we also explored the difference between cancer-related VTE, provoked and unprovoked VTE in term of recurrence and mortality using Kaplan-Meier curves and compared groups using the log-rank test.

Results: Of the 1124 patients with primary VTE, 214 patients developed recurrent VTE and 192 patients died with an overall incidence rates of 15.8 per 100 patient-year (95%CI, 13.8-18.0) and 10.0 per 100 patient-year (95% CI, 8.7-11.5), respectively. Presence of active cancer and Pulmonary embolism (PE) with or without deep vein thrombosis (DVT) were found independent risk factors associated with recurrence (HR, 2.87; 95%CI, 2.02-4.08; p<.001 and HR 2.10; 95%CI 1.57-2.82; p<.001, respectively).  VTE recurrence predicted significantly higher mortality rate (HR, 7.0; 95%CI, 5.00-9.81; p<.001). Using Kaplan-Meier, the estimate recurrence mean time (months) was significantly lower in cancer-related VTE (18.7) than provoked (29.0) and unprovoked VTE (28.4, p<.001 by the log-rank test). The estimate survival mean time (months) was significantly lower in cancer-related VTE (21.8) than in provoked (30.5) and unprovoked VTE (29.8, p<.001 by the log-rank test).

Conclusions: The presence of active cancer and PE with or without DVT were  a statistically significant risk factor for recurrence. Patients who developed recurrent VTE had 7-fold higher mortality rate than patients with no recurrences.

To cite this abstract in AMA style:

Aleidan F, Almanea R, Shalash N, Alrajhi N, Almoneef A, Almousa S, Abuelgasim K. Recurrence and Mortality Following First Venous Thromboembolism among Saudi Population: Single-centre Cohort Study [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/recurrence-and-mortality-following-first-venous-thromboembolism-among-saudi-population-single-centre-cohort-study/. Accessed May 19, 2022.

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