| Risk of recurrence after a first episode of symptomatic venous thromboembolism provoked by a transient risk factor: a systematic review. | |
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MedLine Citation:
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PMID: 20975016 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: We aimed to determine the risk of recurrence for symptomatic venous thromboembolism (VTE) provoked by different transient risk factors. DATA SOURCES: MEDLINE, EMBASE, and Cochrane Collaboration Registry of Randomized Trials databases were searched. STUDY SELECTION: Prospective cohort studies and randomized trials of patients with a first episode of symptomatic VTE provoked by a transient risk factor and treated for at least 3 months were identified. DATA EXTRACTION: Number of patients and recurrent VTE during the 0- to 12-month and 0- to 24-month intervals after stopping therapy, study design, and provoking risk factor characteristics were extracted. DATA SYNTHESIS: Annualized recurrence rates were calculated and pooled across studies. At 24 months, the rate of recurrence was 3.3% per patient-year (11 studies, 2268 patients) for all patients with a transient risk factor, 0.7% per patient-year (3 studies, 248 patients) in the subgroup with a surgical factor, and 4.2% per patient-year (3 studies, 509 patients) in the subgroup with a nonsurgical factor. In the same studies, the rate of recurrence after unprovoked VTE was 7.4% per patient-year. The rate ratio for a nonsurgical compared with a surgical factor was 3.0 and for unprovoked thrombosis compared with a nonsurgical factor was 1.8 at 24 months. CONCLUSIONS: The risk of recurrence is low if VTE is provoked by surgery, intermediate if provoked by a nonsurgical risk factor, and high if unprovoked. These risks affect whether patients with VTE should undergo short-term vs indefinite treatment. |
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Authors:
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Alfonso Iorio; Clive Kearon; Esmeralda Filippucci; Maura Marcucci; Ana Macura; Vittorio Pengo; Sergio Siragusa; Gualtiero Palareti |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Archives of internal medicine Volume: 170 ISSN: 1538-3679 ISO Abbreviation: Arch. Intern. Med. Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-10-26 Completed Date: 2010-11-09 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0372440 Medline TA: Arch Intern Med Country: United States |
Other Details:
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Languages: eng Pagination: 1710-6 Citation Subset: AIM; IM |
Affiliation:
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Department of Internal Medicine, University of Perugia, Italy. iorioa@mcmaster.ca |
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| MeSH Terms | |
Descriptor/Qualifier:
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Humans Incidence Prognosis Recurrence Risk Assessment / methods* Risk Factors Venous Thromboembolism / epidemiology* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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