Thromb Haemost 2022; 122(06): 1017-1026
DOI: 10.1055/s-0041-1740184
Stroke, Systemic or Venous Thromboembolism

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

Jonas Florin
1   Department of General Internal Medicine, Bern University Hospital (Inselspital), University of Bern, Bern, Switzerland
,
Odile Stalder
2   CTU Bern, University of Bern, Bern, Switzerland
,
Christine Baumgartner
1   Department of General Internal Medicine, Bern University Hospital (Inselspital), University of Bern, Bern, Switzerland
,
Marie Méan
3   Service of Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland
,
Nicolas Rodondi
1   Department of General Internal Medicine, Bern University Hospital (Inselspital), University of Bern, Bern, Switzerland
4   Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
,
Drahomir Aujesky
1   Department of General Internal Medicine, Bern University Hospital (Inselspital), University of Bern, Bern, Switzerland
› Author Affiliations
Funding This study was funded by Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (33CSCO-122659/139470).

Abstract

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.



Publication History

Received: 19 July 2021

Accepted: 10 October 2021

Article published online:
28 December 2021

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