Thrombophilic abnormalities and recurrence of venous thromboembolism in patients treated with standardized anticoagulant treatment

Maria Gabriella Santamaria, Giancarlo Agnelli, Maria Rita Taliani, Paolo Prandoni, Marco Moia, Mario Bazzan, Giuliana Guazzaloca, Walter Ageno, Adriano Bertoldi, Mauro Silingardi, Cristina Tomasi, Giovan Battista Ambrosio

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Abstract

Introduction: Whether patients with hereditary or acquired thrombophilia have an increased risk for recurrence of venous thromboembolism (deep vein thrombosis and/or pulmonary embolism) is still controversial. The aim of this study was to evaluate the incidence of recurrence of venous thromboembolism in patients with and without thrombophilic abnormalities treated with standardized anticoagulant treatment. Material and methods: Database was from a prospective multicenter randomized study aimed at evaluating the long-term clinical benefit of extending to 1 year the 3-month oral anticoagulant treatment after a first episode of idiopathic proximal deep vein thrombosis. The screening for thrombophilia included antithrombin, protein C, protein S deficiencies, resistance to activated protein C and/or factor V R506Q mutation, the mutation 20210GA of the prothrombin gene, hyperhomocysteinemia and antiphospholipid antibodies. The diagnosis of venous thromboembolism recurrence was done by objective tests and adjudicated by a panel unaware of the results of the thrombophilia screening. Results: A screening for thrombophilic abnormalities was performed in 195 patients. Twenty of 57 (35.1%) thrombophilic patients experienced a recurrence of venous thromboembolism as compared with 29 of 138 (21.0%) patients without thrombophilia (HR=1.78, 95% CI 1.002-3.140, p=0.046). The difference in VTE recurrence between patients with and without thrombophilia was accounted for by those who received 3 months of oral anticoagulation (HR=3.21, 95% CI 1.349-7.616, p=0.008). No difference between thrombophilic and non-thrombophilic patients was observed in the time interval from the index episode to recurrent venous thromboembolism (29.1±23.9 and 30.6±19.8 months, respectively). Conclusions: Thrombophilic abnormalities are associated with an increased risk of venous thromboembolism recurrence. The role of thrombophilia in the long-term management of venous thromboembolism should be addressed in prospective management studies.

Original languageEnglish
Pages (from-to)301-306
Number of pages6
JournalThrombosis Research
Volume116
Issue number4
DOIs
Publication statusPublished - 2005

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Keywords

  • Deep vein thrombosis
  • Pulmonary embolism
  • Thrombophilia
  • Venous thromboembolism

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Hematology

Cite this

Santamaria, M. G., Agnelli, G., Taliani, M. R., Prandoni, P., Moia, M., Bazzan, M., Guazzaloca, G., Ageno, W., Bertoldi, A., Silingardi, M., Tomasi, C., & Ambrosio, G. B. (2005). Thrombophilic abnormalities and recurrence of venous thromboembolism in patients treated with standardized anticoagulant treatment. Thrombosis Research, 116(4), 301-306. https://doi.org/10.1016/j.thromres.2004.12.012