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Siragusa, Sergio; Malato, Alessandra; Saccullo, Giorgia; Iorio, Alfonso; Di Ianni, Mauro; Caracciolo, Clementina; Coco, Lucio Lo; Raso, Simona; Santoro, Marco; Guarneri, Francesco Paolo; Tuttolomondo, Antonino; Pinto, Antonio; Pepe, Iliana; Casuccio, Alessandra; Abbadessa, Vincenzo; Licata, Giuseppe; Battista Rini, Giovan; Mariani, Guglielmo; Di Fede, Gaetana

Residual vein thrombosis for assessing duration of anticoagulation after unprovoked deep vein thrombosis of the lower limbs: The extended DACUS study

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  • Media type: E-Article
  • Title: Residual vein thrombosis for assessing duration of anticoagulation after unprovoked deep vein thrombosis of the lower limbs: The extended DACUS study
  • Contributor: Siragusa, Sergio; Malato, Alessandra; Saccullo, Giorgia; Iorio, Alfonso; Di Ianni, Mauro; Caracciolo, Clementina; Coco, Lucio Lo; Raso, Simona; Santoro, Marco; Guarneri, Francesco Paolo; Tuttolomondo, Antonino; Pinto, Antonio; Pepe, Iliana; Casuccio, Alessandra; Abbadessa, Vincenzo; Licata, Giuseppe; Battista Rini, Giovan; Mariani, Guglielmo; Di Fede, Gaetana
  • imprint: Wiley, 2011
  • Published in: American Journal of Hematology
  • Language: English
  • DOI: 10.1002/ajh.22156
  • ISSN: 0361-8609; 1096-8652
  • Keywords: Hematology
  • Origination:
  • Footnote:
  • Description: <jats:title>Abstract</jats:title><jats:p>The safest duration of anticoagulation after idiopathic deep vein thrombosis (DVT) is unknown. We conducted a prospective study to assess the optimal duration of vitamin K antagonist (VKA) therapy considering the risk of recurrence of thrombosis according to residual vein thrombosis (RVT). Patients with a first unprovoked DVT were evaluated for the presence of RVT after 3 months of VKA administration; those without RVT suspended VKA, while those with RVT continued oral anticoagulation for up to 2 years. Recurrent thrombosis and/or bleeding events were recorded during treatment (RVT group) and 1 year after VKA withdrawal (both groups). Among 409 patients evaluated for unprovoked DVT, 33.2% (136 of 409 patients) did not have RVT and VKA was stopped. The remaining 273 (66.8%) patients with RVT received anticoagulants for an additional 21 months; during this period of treatment, recurrent venous thromboembolism and major bleeding occurred in 4.7% and 1.1% of patients, respectively. After VKA suspension, the rates of recurrent thrombotic events were 1.4% and 10.4% in the no‐RVT and RVT groups, respectively (relative risk = 7.4; 95% confidence interval = 4.9–9.9). These results indicate that in patients without RVT, a short period of treatment with a VKA is sufficient; in those with persistent RVT, treatment extended to 2 years substantially reduces, but does not eliminate, the risk of recurrent thrombosis. Am. J. Hematol. 2011. © 2011 Wiley‐Liss, Inc.</jats:p>
  • Access State: Open Access