Recurrent Venous Thromboembolism: What Is the Risk and How to Prevent It

Abstract

Venous thromboembolism (VTE) that includes deep vein thrombosis and/or pulmonary embolism is a frequent, severe, and potentially lethal disease. After a first episode, VTE has a strong tendency to recur. While VTE is an acute disease, it may have variable outcomes in early and late phases after initial presentation. Furthermore, the incidence of late, clinically important consequences (postthrombotic syndrome and/or chronic thromboembolic pulmonary hypertension) increases in case of recurrent events. The aims of the present review are (i) to analyze the incidence and risk factors for recurrence of VTE (either those related to the type of first thrombotic event or to the patients), the risks associated with occurrence of recurrent events, and the problems linked to the diagnosis, not always easy, of recurrent events; (ii) to discuss whether or not it is possible to predict the individual risk of recurrence after a first event, by stratifying patients at high or low risk of recurrence, and how this can influence their treatment; (iii) to comment what the current guidelines and guidance suggest/recommend about anticoagulant treatment after a first VTE event and, finally, to propose practical indications on how to manage individual patients affected by VTE.

Economic burden of recurrent venous thromboembolism: Analysis from a U.S. hospital perspective

“…The relationships of male sex and cancer to an increased risk of VTE recurrence found in our research are widely established in the literature. 16,22,23,[26][27][28] There is no unanimous consensus on the effect of age on the risk of recurrent VTE, and advancing age has been reported to be associated with both increased and decreased recurrence risk in different studies. 12 In our study, we found an inverse relationship between age and the risk of recurrent VTE in an adjusted analysis.…”

Tekrarlayan Venöz Tromboemboli’ye Trombofilik Gen Mutasyonunun Etkisi: Geriye-Dönük Kesitsel Bir Araştırma

“…The literature comprises a substantial number of studies that have investigated the risk factors, including the TGMs that may play a key role for rVTE (1,4,5,(8)(9)(10)(11)(12)(13). Although presence of TGM as a risk factor for the index VTE event is undisputed, its impact on the rVTE is a highly debated issue (1,4,5,(9)(10)(11)(12)(14)(15)(16)(17)(18)(19).…”

Weekly risk of venous thromboembolism recurrence in patients receiving oral anticoagulants

“…This corresponds to annualized risks of recurrent VTE of 40.6% for Week 1, 43.2% for Week 2, 32.8% for Week 3, 27.0% for Week 4, and 20.3% for Week 5. For Weeks 6,7,8,9,10,11, and 12, the annualized risks of recurrent VTE were the following, respectively: 16.6%, 13.5%, 10.4%, 13.0%, 12.0%, and 12.0%.…”

“…VTE events can be triggered by multiple factors and are typically classified as provoked, unprovoked, and cancer-related. Patients with a provoked VTE event, a consequence of risk factors such as surgery and trauma, have been associated with a three-fold smaller risk of VTE recurrence compared to patients with unprovoked VTE; patients with cancer have been associated with a two-to four-fold higher risk of VTE recurrence compared to other patients [6][7][8][9][10] .…”