Titre du document / Document title

The risk of recurrent venous thromboembolism in patients with and without factor V Leiden

Auteur(s) / Author(s)

EICHINGER S. ⁽¹⁾ ; PABINGER I. ⁽¹⁾ ; STÜMPFLEN A. ⁽²⁾ ; HIRSCHL M. ⁽³⁾ ; BIALONCZYK C. ⁽⁴⁾ ; SCHNEIDER B. ⁽⁵⁾ ; MANNHALTER C. ⁽⁶⁾ ; MINAR E. ⁽²⁾ ; LECHNER K. ⁽¹⁾ ; KYRLE P. A. ⁽¹⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Department of Internal Medicine I, Division of Hematology and Hemostaseology, University of Vienna, Vienna, AUTRICHE
⁽²⁾ Department of Internal Medicine II, Division of Angiology, University of Vienna, Vienna, AUTRICHE
⁽³⁾ Hanuschkrankenhaus, Vienna, AUTRICHE
⁽⁴⁾ Wilhelminenspital, Vienna, AUTRICHE
⁽⁵⁾ Department of Medical Statistics, University of Vienna, AUTRICHE
⁽⁶⁾ Department of Laboratory Medicine, University of Vienna, AUTRICHE

Résumé / Abstract

Thromboprophylaxis with oral anticoagulants up to six months is established in patients after a first venous thromboembolic event (VTE). The risk of recurrent VTE is still considerable thereafter, and it is uncertain whether some patients might benefit from extended anticoagulation. We performed a prospective, multicenter trial (4 thrombosis centers) and evaluated in 380 patients with a first or recurrent VTE (patients with a deficiency of antithrombin, protein C, protein S or plasminogen; cancer; or an antiphospholipid antibody syndrome were excluded) the risk of recurrence after discontinuation of secondary thromboprophylaxis with oral anticoagulants. It was the aim of the study to evaluate whether patients with factor V Leiden are at an increased risk of recurrent VTE. 112 (29.5%) patients were carriers of factor V Leiden (26.9% heterozygous, 2.6% homozygous). After a median observation time of 19.3 months the overall recurrence rate of VTE was 9.9%. Recurrent deep vein thrombosis and/or pulmonary embolism occurred in 26 of 268 patients without factor V Leiden (9.7%) and in 10 of 112 patients with factor V Leiden (8.9%). The probability of recurrent VTE two years after discontinuation of oral anticoagulants was 12.4% (95% CI 7.8-17) in patients without factor V Leiden and was 10.6% (95% CI 3.8-17.4) in carriers of the mutation. This difference was statistically not significant. Patients with factor V Leiden are not at a higher risk of recurrent VTE within two years after discontinuation of oral anticoagulants than patients without factor V Leiden. Balancing the risk of recurrent VTE and bleeding from oral anticoagulants, patients with factor V Leiden are not likely to benefit from oral anticoagulant therapy extended beyond six months.

Revue / Journal Title

Thrombosis and haemostasis   ISSN 0340-6245   CODEN THHADQ 

Source / Source

1997, vol. 77, n^o4, pp. 624-628 (33 ref.)

Langue / Language

Anglais

Editeur / Publisher

Schattauer, Stuttgart, ALLEMAGNE  (1976) (Revue)

Mots-clés anglais / English Keywords

Thrombosis ; Vein ; Thromboembolism ; Risk factor ; Human ; Factor V Leiden ; Cardiovascular disease ; Vascular disease ; Venous disease ; Hemopathy ; Coagulopathy ; Genetic disease ;

Mots-clés français / French Keywords

Thrombose ; Veine ; Thromboembolie ; Facteur risque ; Homme ; Facteur V Leiden ; Appareil circulatoire pathologie ; Vaisseau sanguin pathologie ; Veine pathologie ; Hémopathie ; Coagulopathie ; Maladie héréditaire ;

Mots-clés espagnols / Spanish Keywords

Trombosis ; Vena ; Tromboembolia ; Factor riesgo ; Hombre ; Aparato circulatorio patología ; Vaso sanguíneo patología ; Vena patología ; Hemopatía ; Coagulopatía ; Enfermedad hereditaria ;

Localisation / Location

INIST-CNRS, Cote INIST : 10255, 35400006485149.0040