Abstract
Essentials Is remote exposure to major venous thromboembolism (VTE) risk factor related to lower recurrence? We analyzed data from the REVERSE study, a cohort of patients with no recent major risk factor. We found no association between remote risk factors and the risk of recurrence. Patients with remote VTE risk factor should be managed as having had an unprovoked VTE. Summary: Background It has been shown that the risk of recurrence of venous thromboembolism (VTE) is significantly lower when provoked by a major risk factor such as surgery or trauma compared with an event that was unprovoked. Objectives In this study we aimed to assess the association between remote exposure (3–12 months prior to VTE) to major VTE risk factors and the risk of recurrent VTE. Methods This was a post-hoc analysis of the REVERSE study, a prospective cohort of 646 patients with a first VTE, not provoked by a recent (< 3 months) major risk factor. Results We found no difference in the recurrence rate in patients with or without remote exposure to major VTE risk factors, including immobilization (hazard-ratio [HR], 1.4; 95% confidence interval, 0.7–2.6), surgery (HR, 0.8; 0.3–1.9) and trauma (HR, 1.3; 0.5–3.6). Conclusion None of the tested risk factors were associated with a lower risk of recurrence during follow-up. Patients with remote exposure to major risk factors at the time of a first VTE should not be managed differently from patients with no VTE risk factors.
| Original language | English |
|---|---|
| Pages (from-to) | 1977-1980 |
| Number of pages | 4 |
| Journal | Journal of Thrombosis and Haemostasis |
| Volume | 15 |
| Issue number | 10 |
| DOIs | |
| Publication status | Published - Oct 2017 |
Bibliographical note
Funding Information:G. Le Gal reports grants from bioMérieux, during the conduct of the study. M. Crowther reports personal fees from CSL Behring, Asahi Kasei Pharma America, Boehringer Ingelheim, LEO Pharma, Octapharma, Pfizer, Portola Pharmaceuticals, Ortho Clinical Diagnostics, Alexion Pharmaceuticals, Bayer AG, Bristol-Myers Squibb, Celgene, and Daiichi Sankyo, outside the submitted work. P. S. Wells reports personal fees from Dai-ichi-Sankyo and Bayer Healthcare, and grants from BMS, outside the submitted work. R. White reports
Funding Information:
Funding: The REVERSE study was funded by the Canadian Institutes of Health Research (grant no. MOP 64319) and bioMérieux (through an unrestricted research grant).
Funding Information:
The study investigators are members of the CanVECTOR network funded by the Canadian Institutes of Health Research. M. Rodger holds a Heart and Stroke Foundation of Canada Career Scientist Award, and holds a University of Ottawa Faculty of Medicine Clinical Research Chair. G. Le Gal holds a Heart and Stroke Foundation of Ontario Clinician Scientist ‘CP has Heart’ Cardiovascular Award, an Early Researcher Award from the province of Ontario, and the University of Ottawa Department of Medicine Chair on Diagnosis of Venous Thromboembolism. We thank A. Perrier and L. Vickars from the REVERSE Investigators.
Publisher Copyright:
© 2017 International Society on Thrombosis and Haemostasis
ASJC Scopus Subject Areas
- Hematology