Epidemiology of recurrent venous thrombosis

Abstract

Venous thrombosis, including deep vein thrombosis and pulmonary embolism, is a common disease that frequently recurs. Recurrence can be prevented by anticoagulants, but this comes at the risk of bleeding. Therefore, assessment of the risk of recurrence is important to balance the risks and benefits of anticoagulant treatment. This review briefly outlines what is currently known about the epidemiology of recurrent venous thrombosis, and focuses in more detail on potential new risk factors for venous recurrence. The general implications of these findings in patient management are discussed.

Von Willebrand factor is reversibly decreased during torpor in 13-lined ground squirrels

“…Thus, the combined drops in FVIII and FIX activity during torpor contribute to an induced hemophilia-like state, and could account for the prolonged APTT times. Elevated FVIII and FIX are risk factors for DVT, thus their decreased levels could help protect hibernating ground squirrels from stasis-induced blood clots (Bertina 2003; Flinterman et al 2010; Ribeiro et al 2012). …”

“…In humans both immobilization that decreases blood flow and tissue damage from a traumatic event increase the risk of DVT by 10- to 20-fold (Heit et al 1999, 2000; Esmon 2009). An increase in the level of procoagulant proteins (e.g., clotting factors, fibrinogen, von Willebrand factor-vWF) or a reduced level of anticoagulant proteins (e.g., antithrombin, protein C) increases the risk for thrombosis and embolism (Bertina 2003; Kuipers et al 2009; Bittar et al 2010; Flinterman et al 2010; Ribeiro et al 2012). Platelets, monocytes, and neutrophils also contribute to DVT through the formation of DNA neutrophil extracellular traps (NETS) in baboon and mouse models (Chauhan et al 2007; Fuchs et al 2010; Brill et al 2011).…”

Family history of venous thromboembolism (VTE) and risk of recurrent hospitalization for VTE: a nationwide family study in Sweden

“…Venous thromboembolism (VTE), which comprises deep vein thrombosis (DVT) of the lower extremities and pulmonary embolism (PE), is often a chronic disease, with a risk of recurrence within 5 years of~25% [1][2][3]. VTE recurrence can be prevented with anticoagulants, but their use increases the risk of bleeding [4][5][6].…”

“…Risk assessment is therefore important to balance the risks and benefits of anticoagulant therapy [4][5][6]. However, the risk of recurrent thrombosis after stopping treatment is not easily predicted, although a number of risk factors for recurrent VTE have been identified [1][2][3][4][5][6][7]. The risk of recurrent VTE is especially high in patients with unprovoked VTE (i.e.…”

“…The risk of recurrent VTE is especially high in patients with unprovoked VTE (i.e. VTE in the absence of transitory risk factors such as surgery, trauma, pregnancy, and oral contraceptive use) [1][2][3][4][5][6][7]. Other risk factors for recurrent VTE include PE (as compared with DVT), proximal DVT (as compared with distal DVT), male sex, cancer, obesity, residual venous thrombosis, and elevated D-dimer levels [1][2][3][4][5][6][7].…”