Wiener Klinische Wochenschrift

, Volume 115, Issue 13–14, pp 471–474

The risk of recurrent venous thromboembolism: The Austrian Study on Recurrent Venous Thromboembolism

Review Article

Abstract

Venous thromboembolism (VTE) is a chronic disease. After withdrawal of oral anticoagulation at least a third of patients will experience a subsequent episode of venous thrombosis. Of these patients, approximately 5% will die from pulmonary embolism. The Austrian Study on Recurrent Venous Thromboembolism (AUREC) is a prospective cohort study aiming to investigate the overall rate of recurrent VTE, the predictive value of laboratory assays, the importance of acquired or congenital risk factors for thrombosis and the impact of extended or modified secondary thromboprophylaxis on the risk of recurrence among high-risk patients. So far, the AUREC investigators have identified subgroups of patients with a particular high risk of recurrence: patients with a history of venous thrombosis, elevated levels of coagulation factors VIII, IX and XI, pulmonary embolism or superficial venous thrombosis and a history of venous thrombosis and hyperhomocysteinemia. Patients with a history of venous thrombosis and mutations in genes encoding for coagulation factors (factor V Leiden, factor II, G20210A) do not have an enhanced risk of recurrence and, thus, do not qualify for extended secondary thromboprophylaxis. At present, interventional trials are in progress in patients with high factor VIII or hyperhomocysteinemia in order to investigate if these patient groups might benefit from extended oral anticoagulation or vitamin supplementation, respectively.

Keywords

Venous thromboembolism recurrence thrombotic risk factors 

Das Rezidivrisiko der venösen Thromboembolie

Zusammenfassung

Die venöse Thromboembolie (VTE) ist eine chronische Erkrankung. Nach Beendigung der oralen Antikoagulantientherapie erleidet ca. ein Drittel der Patienten ein neuerliches thromboembolisches Ereignis. 5% dieser Patienten sterben an der Pulmonalembolie. Die Austrian Study on Recurrent Venous Thromboembolism (AUREC) ist eine prospektive Kohortenstudie und hat zum Ziel, die Gesamtrezidivrate der VTE, den prädiktiven Wert von Laboruntersuchungen, die Bedeutung von angeborenen und erworbenen thrombotischen Risikofaktoren und den Einfluss einer länger dauernden bzw. modifizierten sekundären Thromboseprophylaxe auf das Rezidivrisiko von Hochrisikopatienten zu untersuchen. Bislang gelang es den AUREC Untersuchern Subgruppen von Patienten mit einem erhöhten Rezidivrisiko zu identifizieren. Patienten mit einer anamnestischen VTE, erhöhten Faktor VIII-, Faktor IX- und Faktor XI-Spiegeln, einer anamnestischen Pulmonalembolie oder einer oberflächlichen Venenthrombose nach VTE sowie Patienten mit Hyperhomocysteinämie. Patienten mit der Faktor V Leiden Mutation oder der G20210A Mutation im Prothrombingen haben kein erhöhtes Rezidivrisiko und benötigen daher keine länger dauernde Sekundärprophylaxe. Zur Zeit werden interventionelle Studien bei Patienten mit hohem Faktor VIII oder Hyperhomocysteinämie durchgeführt um zu untersuchen, ob eine länger dauernde Sekundärprophylaxe mit oralen Antikoagulantien oder die Verabreichung von Folsäure, Vitamin B6 und Vitamin B12 das Rezidivrisiko senken.

Schlüsselwörter

Venöse Thromboembolie Rezidiv thrombotische Risikofaktoren 

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Copyright information

© Springer 2003

Authors and Affiliations

  1. 1.Division of Hematology and HemostasisVienna University HospitalViennaAustria
  2. 2.the Ludwig Boltzmann-Institute for Thrombosis Research, Department of Internal Medicine IVienna University HospitalViennaAustria

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