Venous thromboembolism: Risk factors for recurrence

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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. © 2009 American Heart Association, Inc.

Author-supplied keywords

  • *venous thromboembolism/dt [Drug Therapy]
  • D dimer
  • anticoagulant agent/dt [Drug Therapy]
  • anticoagulant agent/po [Oral Drug Administration]
  • antiphospholipid syndrome
  • antivitamin K/cm [Drug Comparison]
  • antivitamin K/ct [Clinical Trial]
  • antivitamin K/dt [Drug Therapy]
  • article
  • cancer risk
  • cardiovascular risk
  • clinical feature
  • clinical trial
  • drug efficacy
  • drug safety
  • drug withdrawal
  • ethnicity
  • human
  • low molecular weight heparin/cm [Drug Comparison]
  • low molecular weight heparin/ct [Clinical Trial]
  • low molecular weight heparin/dt [Drug Therapy]
  • metastasis
  • priority journal
  • prognosis
  • prophylaxis
  • recurrent disease
  • sex difference
  • thrombin/ec [Endogenous Compound] XT - antivitami
  • thrombophilia
  • thrombosis
  • vein thrombosis

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  • Zhu T.

  • Martinez I.

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