Management of patients with venous thromboembolism and a high recurrence risk estimated by the Vienna Prediction Model: a prospective cohort study
Background: The Vienna Prediction Model (VPM) identifies patients with a first unprovoked deep vein thrombosis of the leg and/or pulmonary embolism who have a low recurrence risk and may, therefore, not benefit from extended-phase anticoagulation. Objectives: The aim of this study was to evaluate pa...
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Elsevier
2025-01-01
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| Series: | Research and Practice in Thrombosis and Haemostasis |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2475037924003443 |
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| author | Hana Šinkovec Paul A. Kyrle Lisbeth Eischer Paul Gressenberger Thomas Gary Marianne Brodmann Georg Heinze Sabine Eichinger |
| author_facet | Hana Šinkovec Paul A. Kyrle Lisbeth Eischer Paul Gressenberger Thomas Gary Marianne Brodmann Georg Heinze Sabine Eichinger |
| author_sort | Hana Šinkovec |
| collection | DOAJ |
| description | Background: The Vienna Prediction Model (VPM) identifies patients with a first unprovoked deep vein thrombosis of the leg and/or pulmonary embolism who have a low recurrence risk and may, therefore, not benefit from extended-phase anticoagulation. Objectives: The aim of this study was to evaluate patients with a predicted high risk of recurrent venous thromboembolism (VTE). Methods and Results: We prospectively followed 266 patients in whom the VPM had predicted a recurrence risk of more than 5.5% at 1 year for a median of 13.5 months. Their median age was 56 years, and 96% were men. After the VPM risk assessment, 196 patients restarted anticoagulation. While on anticoagulation, none of the patients experienced recurrent VTE, whereas 4 patients had nonmajor clinically relevant bleeding (absolute bleeding rate, 1.8 [95% CI, 0.5-4.5] events per 100 patient-years). Seventy patients were left untreated after VPM risk assessment for various reasons. Among patients not using anticoagulation, 15 had recurrence (absolute recurrence rate, 18.1 [95% CI, 10.1, 29.9] events per 100 person-years). According to the extended Kaplan–Meier analysis, the probability of VTE recurrence in patients not on anticoagulation was 10.1% and 17.9% at 6 and 12 months after VPM risk assessment, respectively. Conclusion: Anticoagulant therapy is effective and safe in patients with an unprovoked VTE, in whom the VPM had predicted a high risk of recurrent VTE. If these patients are left untreated, the risk of recurrence is high. |
| format | Article |
| id | doaj-art-4c1c7677c1e743f98ad813e88b230a5f |
| institution | Kabale University |
| issn | 2475-0379 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Research and Practice in Thrombosis and Haemostasis |
| spelling | doaj-art-4c1c7677c1e743f98ad813e88b230a5f2024-12-28T05:22:32ZengElsevierResearch and Practice in Thrombosis and Haemostasis2475-03792025-01-0191102649Management of patients with venous thromboembolism and a high recurrence risk estimated by the Vienna Prediction Model: a prospective cohort studyHana Šinkovec0Paul A. Kyrle1Lisbeth Eischer2Paul Gressenberger3Thomas Gary4Marianne Brodmann5Georg Heinze6Sabine Eichinger7Center for Medical Data Science, Institute of Clinical Biometrics, Medical University of Vienna, Vienna, AustriaDivision of Hematology and Hemostasis, Department of Medicine I, Medical University of Vienna, Vienna, Austria; Karl Landsteiner Institute of Thrombosis Research, Vienna, Austria; Correspondence Paul A. Kyrle, Division of Hematology and Hemostasis, Department of Medicine I, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.Division of Hematology and Hemostasis, Department of Medicine I, Medical University of Vienna, Vienna, AustriaDivision of Angiology, Department of Medicine, Medical University of Graz, Graz, AustriaDivision of Angiology, Department of Medicine, Medical University of Graz, Graz, AustriaDivision of Angiology, Department of Medicine, Medical University of Graz, Graz, AustriaCenter for Medical Data Science, Institute of Clinical Biometrics, Medical University of Vienna, Vienna, AustriaDivision of Hematology and Hemostasis, Department of Medicine I, Medical University of Vienna, Vienna, AustriaBackground: The Vienna Prediction Model (VPM) identifies patients with a first unprovoked deep vein thrombosis of the leg and/or pulmonary embolism who have a low recurrence risk and may, therefore, not benefit from extended-phase anticoagulation. Objectives: The aim of this study was to evaluate patients with a predicted high risk of recurrent venous thromboembolism (VTE). Methods and Results: We prospectively followed 266 patients in whom the VPM had predicted a recurrence risk of more than 5.5% at 1 year for a median of 13.5 months. Their median age was 56 years, and 96% were men. After the VPM risk assessment, 196 patients restarted anticoagulation. While on anticoagulation, none of the patients experienced recurrent VTE, whereas 4 patients had nonmajor clinically relevant bleeding (absolute bleeding rate, 1.8 [95% CI, 0.5-4.5] events per 100 patient-years). Seventy patients were left untreated after VPM risk assessment for various reasons. Among patients not using anticoagulation, 15 had recurrence (absolute recurrence rate, 18.1 [95% CI, 10.1, 29.9] events per 100 person-years). According to the extended Kaplan–Meier analysis, the probability of VTE recurrence in patients not on anticoagulation was 10.1% and 17.9% at 6 and 12 months after VPM risk assessment, respectively. Conclusion: Anticoagulant therapy is effective and safe in patients with an unprovoked VTE, in whom the VPM had predicted a high risk of recurrent VTE. If these patients are left untreated, the risk of recurrence is high.http://www.sciencedirect.com/science/article/pii/S2475037924003443deep vein thrombosispulmonary embolismvenous thromboembolismVienna Prediction Model recurrence |
| spellingShingle | Hana Šinkovec Paul A. Kyrle Lisbeth Eischer Paul Gressenberger Thomas Gary Marianne Brodmann Georg Heinze Sabine Eichinger Management of patients with venous thromboembolism and a high recurrence risk estimated by the Vienna Prediction Model: a prospective cohort study Research and Practice in Thrombosis and Haemostasis deep vein thrombosis pulmonary embolism venous thromboembolism Vienna Prediction Model recurrence |
| title | Management of patients with venous thromboembolism and a high recurrence risk estimated by the Vienna Prediction Model: a prospective cohort study |
| title_full | Management of patients with venous thromboembolism and a high recurrence risk estimated by the Vienna Prediction Model: a prospective cohort study |
| title_fullStr | Management of patients with venous thromboembolism and a high recurrence risk estimated by the Vienna Prediction Model: a prospective cohort study |
| title_full_unstemmed | Management of patients with venous thromboembolism and a high recurrence risk estimated by the Vienna Prediction Model: a prospective cohort study |
| title_short | Management of patients with venous thromboembolism and a high recurrence risk estimated by the Vienna Prediction Model: a prospective cohort study |
| title_sort | management of patients with venous thromboembolism and a high recurrence risk estimated by the vienna prediction model a prospective cohort study |
| topic | deep vein thrombosis pulmonary embolism venous thromboembolism Vienna Prediction Model recurrence |
| url | http://www.sciencedirect.com/science/article/pii/S2475037924003443 |
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