Residual vein thrombosis for assessing duration of anticoagulation after unprovoked deep vein thrombosis of the lower limbs: the extended DACUS study.

6533b833fe1ef96bd129b7c7

RESEARCH PRODUCT

Residual vein thrombosis for assessing duration of anticoagulation after unprovoked deep vein thrombosis of the lower limbs: the extended DACUS study.

Vincenzo Abbadessa Giuseppe Licata Francesco Paolo Guarneri Gaetana Di Fede Antonino Tuttolomondo Lucio Lo Coco Antonio Pinto Iliana Pepe G. Mariani Giorgia Saccullo Giovan Battista Rini Casuccio Alessandra Mauro Di Ianni Sergio Siragusa Simona Raso Alessandra Malato Alfonso Iorio Clementina Caracciolo Marco Santoro

subject

Adult Male medicine.medical_specialty Vitamin K medicine.drug_class Deep vein Hemorrhage Drug Administration Schedule Settore MED/15 - Malattie Del Sangue Recurrence Risk Factors deep vein thrombosis (DVT)Residual vein thrombosis medicine Humans Prospective Studies deep vein thrombosis (DVT); vitamin K antagonist (VKA) therapy; Residual vein thrombosis Prospective cohort study Aged Ultrasonography Venous Thrombosis business.industry Acenocoumarol Anticoagulants Hematology Venous Thromboembolism Vitamin K antagonist Middle Aged medicine.disease Thrombosis Confidence interval Surgery Clinical trial Vein thrombosis vitamin K antagonist (VKA) therapy medicine.anatomical_structure Lower Extremity Relative risk Female Warfarin business

description

Abstract The safest duration of anticoagulation after idiopathic deep vein thrombosis (DVT) is unknown. We conducted a prospective study to assess the optimal duration of vitamin K antagonist (VKA) therapy considering the risk of recurrence of thrombosis according to residual vein thrombosis (RVT). Patients with a first unprovoked DVT were evaluated for the presence of RVT after 3 months of VKA administration; those without RVT suspended VKA, while those with RVT continued oral anticoagulation for up to 2 years. Recurrent thrombosis and/or bleeding events were recorded during treatment (RVT group) and 1 year after VKA withdrawal (both groups). Among 409 patients evaluated for unprovoked DVT, 33.2% (136 of 409 patients) did not have RVT and VKA was stopped. The remaining 273 (66.8%) patients with RVT received anticoagulants for an additional 21 months; during this period of treatment, recurrent venous thromboembolism and major bleeding occurred in 4.7% and 1.1% of patients, respectively. After VKA suspension, the rates of recurrent thrombotic events were 1.4% and 10.4% in the no-RVT and RVT groups, respectively (relative risk = 7.4; 95% confidence interval = 4.9-9.9). These results indicate that in patients without RVT, a short period of treatment with a VKA is sufficient; in those with persistent RVT, treatment extended to 2 years substantially reduces, but does not eliminate, the risk of recurrent thrombosis.

year	journal	country	edition	language
2011-01-01

10.1002/ajh.22156 http://hdl.handle.net/10447/78133