Sex, age and normal post-anticoagulation D-dimer as risk factors for recurrence after idiopathic venous thromboembolism in the Prolong study extension.
Details
Serval ID
serval:BIB_56F282127F83
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Sex, age and normal post-anticoagulation D-dimer as risk factors for recurrence after idiopathic venous thromboembolism in the Prolong study extension.
Journal
Journal of Thrombosis and Haemostasis
Working group(s)
Prolong Investigators
Contributor(s)
Palareti G., Cosmi B., Legnani C., Brusi C., Testa S., Alatri A., Ghirarduzzi A., Iorio A., Tosetto A., Pengo V., Pegoraro C., Iliceto S., Siragusa S., Prisco D., Poli D., Baudo F., Cappelli R., Erba N., La Rosa L., Pattacini C., Quintavalla R., Ria L., Bucherini E., Cerè E., Rossi V., Tiraferri E., Agazzi C., Maria S., Villani C., Frigerio L., Scapoli G., Trifiletti A., Molinatti M., Dori Faccini P., Santi R., Lessiani G., Scarmozzino V., Imbimbo V., Schenone A., Palareti G., Cosmi B., Legnani C., Tosetto A., Tripodi A., Iorio A., Testa S., Ghirarduzzi A., Pattacini C., Pengo V.
ISSN
1538-7836 (Electronic)
ISSN-L
1538-7836
Publication state
Published
Issued date
2010
Volume
8
Number
9
Pages
1933-1942
Language
english
Notes
Publication types: Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
Abstract
BACKGROUND: The PROLONG randomized study showed that patients with an abnormal D-dimer after anticoagulation suspension for a first unprovoked episode of venous thromboembolism (VTE) benefited from anticoagulation resumption. Patients with normal D-dimer after anticoagulation suspension had a low recurrence rate (4.4% patient-years) but their anticoagulation optimal duration remained uncertain.
OBJECTIVES: To assess whether sex and age, in combination with normal D-dimer, are risk factors for VTE recurrence in patients enrolled in the PROLONG study extended follow-up.
METHODS: D-dimer was measured at 1 month after anticoagulation suspension. Patients with a normal D-dimer did not resume anticoagulants, whereas patients with an abnormal D-dimer were randomized either to resume or not anticoagulants. Primary outcome was recurrent VTE.
RESULTS: After excluding patients resuming anticoagulants for abnormal D-dimer, recurrences were higher in males than females [7.4% patient-years - 47/639 vs. 4.3% patient-years - 27/626; hazard ratio (HR) = 1.7; P = 0.027] and in patients aged 65 or older than in younger patients (8.4% patient-years - 50/598 vs. 3.6% patient-years - 24/667; HR = 2.1; P = 0.003). In patients with normal D-dimer and younger than 65, recurrences were higher in males than in females (5.1% vs. 0.4% patient-years; adjusted HR = 10.6; P = 0.023) and both females and males aged 65 years or older had more recurrences (6.6% and 8.1% patient-years, respectively, adjusted HR: 16.0; P = .008 and 16.0; P = 0.008, respectively) than females younger than 65.
CONCLUSIONS: In patients with idiopathic VTE and a normal D-dimer at 1 month after anticoagulation suspension, females younger than 65 had a very low risk of recurrence.
OBJECTIVES: To assess whether sex and age, in combination with normal D-dimer, are risk factors for VTE recurrence in patients enrolled in the PROLONG study extended follow-up.
METHODS: D-dimer was measured at 1 month after anticoagulation suspension. Patients with a normal D-dimer did not resume anticoagulants, whereas patients with an abnormal D-dimer were randomized either to resume or not anticoagulants. Primary outcome was recurrent VTE.
RESULTS: After excluding patients resuming anticoagulants for abnormal D-dimer, recurrences were higher in males than females [7.4% patient-years - 47/639 vs. 4.3% patient-years - 27/626; hazard ratio (HR) = 1.7; P = 0.027] and in patients aged 65 or older than in younger patients (8.4% patient-years - 50/598 vs. 3.6% patient-years - 24/667; HR = 2.1; P = 0.003). In patients with normal D-dimer and younger than 65, recurrences were higher in males than in females (5.1% vs. 0.4% patient-years; adjusted HR = 10.6; P = 0.023) and both females and males aged 65 years or older had more recurrences (6.6% and 8.1% patient-years, respectively, adjusted HR: 16.0; P = .008 and 16.0; P = 0.008, respectively) than females younger than 65.
CONCLUSIONS: In patients with idiopathic VTE and a normal D-dimer at 1 month after anticoagulation suspension, females younger than 65 had a very low risk of recurrence.
Keywords
Age Factors, Aged, Anulants/therapeutic use, Female, Fibrin Fibrinogen Degradation Products/therapeutic use, Follow-Up Studies, Humans, Male, Middle Aged, Recurrence, Risk, Risk Factors, Sex Factors, Time Factors, Treatment Outcome, Venous Thromboembolism/blood, Venous Thromboembolism/therapy
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Web of science
Create date
14/02/2013 16:34
Last modification date
03/06/2020 6:26
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