Long-term recurrence risk after a first venous thromboembolism in men and women under 50 years old: A French prospective cohort

Moreuil, Claire de; Mao, Raphaël Le; Moigne, Emmanuelle Le; Pan‐Petesch, Brigitte; Tromeur, Cécile; Hoffmann, Clément; Salaun, Pierre–Yves; Nonent, Michel; Déserts, Marc Danguy des; Savary, Xavier; Guégan, Marie; Poulhazan, Elise; Leroyer, Christophe; Lacut, Karine; Couturaud, Francis

doi:10.1016/j.ejim.2020.10.014

Cited by 12 publications

(21 citation statements)

References 36 publications

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“…The majority of venous thromboembolism (VTE) events in women younger than 50 years old are provoked by a major transient risk factor or are hormone related. 1 In our French cohort, ~60% of women < 50 years old experienced a first VTE while on estrogen-containing contraceptive and another 20% experienced VTE during pregnancy or in the postpartum period. These women of childbearing age may become pregnant after their first VTE and may need medical counselling about the potential risks related to pregnancy in this specific context.…”

Section: Introductionmentioning

confidence: 80%

“…The majority of venous thromboembolism (VTE) events in women younger than 50 years old are provoked by a major transient risk factor or are hormone related 1 . In our French cohort, ~60% of women < 50 years old experienced a first VTE while on estrogen‐containing contraceptive and another 20% experienced VTE during pregnancy or in the postpartum period.…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for recurrence during a pregnancy following a first venous thromboembolism: A French observational study

Moreuil

Tromeur

Daoudal³

et al. 2022

Journal of Thrombosis and Haemostasis

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Background: Women with a previous venous thromboembolism (VTE) are at risk of recurrence during pregnancy.Objectives: We aimed to assess the incidence rate of recurrent VTE during pregnancy, according to the period of pregnancy, and the clinical parameters associated with recurrence, in a prospective cohort of women of childbearing age after a first VTE.Patients/Methods: A total of 189 women aged 15-49 years with a first documented VTE were followed until a subsequent pregnancy of at least 20 weeks' gestation between 2000 and 2020. VTE recurrences during pregnancy were recorded, as were potential clinical risk factors for recurrence. Results: Recurrent VTE occurred in six women during antepartum: five during the first trimester (incidence rate 106.4 per 1000 women-years) (95% confidence interval [CI] 46.3-226.0); none during the second trimester; and one during the third trimester (incidence rate 27.0 per 1000 women-years [95% CI 4.8-138.2]). During postpartum, recurrences occurred in 11 women (incidence rate 212.8 per 1000 women-years [95% CI 119.9-349.1]). These 17 recurrent VTEs presented as pulmonary embolism ± deep vein thrombosis (DVT) in five patients and isolated DVT in 12. Failure of thromboprophylaxis occurred in two cases (33.3%) antepartum and in 10 cases (90.9%) postpartum.In multivariable analysis, only obesity (defined on prepregnancy body mass index) was associated with recurrent VTE (odds ratio 3.34 [95% CI 1.11-10.05, p = .03]). Conclusions:This study confirms a high risk of recurrent VTE postpartum, despite thromboprophylaxis, in women with a previous VTE. Only obesity was associated with VTE recurrence during pregnancy, suggesting that low-dose anticoagulation might not be appropriate in obese pregnant women.

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Section: Introductionmentioning

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Risk factors for recurrence during a pregnancy following a first venous thromboembolism: A French observational study

Moreuil

Tromeur

Daoudal³

et al. 2022

Journal of Thrombosis and Haemostasis

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“…Overall, 17 to 31% of patients with a first VTE have a positive FH of VTE, [8][9][10][11][12][13] which is considered a marker for known or unknown thrombophilia. 13 Most prior studies examining the association between a FH of VTE and recurrence focused on patients with a first [8][9][10][11][12][13] or unprovoked VTE, 8,11,13 and included predominantly younger patients (mean/median age 34.5-62.7 years). While several studies supported a weak association (HR around 1.5) between a FH among first-degree relatives and VTE recurrence, [8][9][10] those that excluded patients with major thrombophilia did not.…”

Section: Discussionmentioning

confidence: 99%

“…13 Most prior studies examining the association between a FH of VTE and recurrence focused on patients with a first [8][9][10][11][12][13] or unprovoked VTE, 8,11,13 and included predominantly younger patients (mean/median age 34.5-62.7 years). While several studies supported a weak association (HR around 1.5) between a FH among first-degree relatives and VTE recurrence, [8][9][10] those that excluded patients with major thrombophilia did not. [11][12][13] A study found an interaction between age and FH, with a FH having a stronger effect on VTE risk in younger patients.…”

Section: Discussionmentioning

confidence: 99%

“…While a FH of VTE in first-degree relatives is a strong risk factor for a first VTE episode, 7 several cohort studies have also shown an independent association between FH and recurrent VTE, 8 9 10 but others did not. 11 12 13 These studies focused on patients with a first 8 9 10 11 12 13 or unprovoked VTE, 8 11 13 or excluded older patients.…”

Section: Introductionmentioning

confidence: 99%

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Do Patients with a Family or Personal History of Venous Thromboembolism have an Increased Risk of Recurrence?

et al. 2021

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Background A family (FH) and personal history (PH) of venous thromboembolism (VTE) are commonly evaluated risk factors for recurrence. We examined the association between FH/PH of VTE and the risk of recurrence and whether a stronger history status (i.e., both FH/PH vs. no FH/PH) carries an increased recurrence risk. Methods We prospectively followed 813 patients aged ≥ 65 years with acute VTE from 9 Swiss hospitals. We classified patients into four groups: no FH/PH, FH only, PH only, and both FH/PH. The primary outcome was recurrent VTE during the full observation period. We examined the association between FH/PH status and the time to VTE recurrence using competing risk regression, adjusting for confounders and periods of anticoagulation. Results Of 813 patients with VTE, 59% had no FH/PH, 11% a FH only, 24% a PH only, and 7% had both a FH and PH of VTE. Overall, 105 patients had recurrent VTE during the full observation period. After adjustment, patients with a FH only (subhazard ratio [SHR] 0.8, 95% confidence interval [CI] 0.4–1.7), PH only (SHR 1.5, 95% CI 0.9–2.5), and both FH/PH (SHR 1.4, 95% CI 0.6–3.1) did not have an increased risk of recurrent VTE compared with those without FH/PH. When we considered the period after the completion of initial anticoagulation only, the results were similar. Conclusion Our findings indicate that in patients with acute VTE, a FH and/or PH of VTE does not convey an increased risk of recurrent VTE. In particular, we did not find a “dose–effect” relationship between FH/PH status and VTE recurrence.

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Sex, age and venous thrombosis—Are men and women indeed from different planets?

Eichinger

Kyrle

2021

European Journal of Internal Medicine

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Long-term recurrence risk after a first venous thromboembolism in men and women under 50 years old: A French prospective cohort

Cited by 12 publications

References 36 publications

Risk factors for recurrence during a pregnancy following a first venous thromboembolism: A French observational study

Risk factors for recurrence during a pregnancy following a first venous thromboembolism: A French observational study

Do Patients with a Family or Personal History of Venous Thromboembolism have an Increased Risk of Recurrence?

Sex, age and venous thrombosis—Are men and women indeed from different planets?

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