Predicting the risk of recurrent venous thrombosis: Impact and
therapeutic consequences of inherited thrombophilia
Abstract
Rationale, aims and objectives :Over the past decades, thrombophilia
testing in patients with venous thrombo-embolism (VTE) has increased
tremendously. However, the role of inherited thrombophilia (IT) in
prediction the risk of recurrence remains controversial. Consequently,
it is still unclear whether thrombophilia testing influences decisions
regarding duration of anticoagulation in clinical practices. The aim of
this study was to evaluate the impact if IT on VTE treatment decisions
and on predicting the risk of recurrence. Methods : A retrospective
longitudinal study (January 2011-Decembre 2016) including 190 patients
with confirmed VTE referred from internal medicine department for
inherited thrombophilia screening was carried out. Results : The mean
age patients was 40.2 years and the sex ratio (M/F) was 0.78. IT was
confirmed in 27.5% of patients. A long term anticoagulation was decided
in 51.6% of patients with IT. There was no significant difference in
the duration of anticoagulation between patients with or without IT. VTE
recurrence was recorded in 26 (13.7 %) patients. The 24 years
cumulative incidence of recurrence was 9% in patients with IT and 14%
in those without. IT was not associated with increased risk of
recurrence after treatment withdrawal (Hazard ratio=1.31 IC(0.47-3.63);
p=0.6). Conclusion : In clinical practice, IT did not influence
anticoagulation duration and was not associated with a higher VTE risk
of recurrence. It seems to be less relevant for decision making than
presumed.