Highlights
- •Recurrences among patients with index venous thromboembolism in pregnancy/puerperium.
- •Venous thromboembolism recurrence was 3.3% (CI: 95 1.5–5.0%) within the first two years.
- •Incidence rate was 2.28 events/100 patients-year.
- •Thrombolytics or inferior vena cava filter use shows increased recurrence risk.
- •Only a minority of recurrences was diagnosed after therapy discontinuation.
Abstract
Introduction
The aim of this study was to investigate the recurrence rate of venous thromboembolism
(VTE) and the prevalence of major bleeding or death in patients with previous VTE
in pregnancy and puerperium. Risk factors for VTE recurrence were also assessed.
Materials and methods
We evaluated a cohort of patients enrolled in the international, multicenter, prospective
Registro Informatizado de la Enfermedad Trombo-Embólica (RIETE) registry with objectively
confirmed VTE.
Results
In the registry, 607 women were presenting with VTE that occurred during pregnancy
or puerperium. The 2-year VTE recurrence rate was 3.3% (CI: 95 1.5–5.0%) and the recurrent
VTE incidence rate was 2.28 events/100 patients-year. Among the 16 cases of VTE recurrence 11 cases appeared during
drug treatment while only five cases were diagnosed after therapy discontinuation.
No significant difference was found in treatment duration among these two subgroups
of VTE recurrence cases and women without recurrence. Furthermore, the use of thrombolytics
and inferior vena cava filter in initial treatment was associated to an increased
risk of VTE recurrence.
Conclusions
The current study provides new insights on VTE recurrence rate in patients with deep
vein thrombosis (DVT) or pulmonary embolism (PE) that occurred in pregnancy or postpartum
period. These findings can contribute to risk assessment of thrombotic burden, thereby
allowing for better decision making regarding antithrombotic management in this clinical
setting.
Abbreviations:
VTE (venous thromboembolism), DVT (deep vein thrombosis), IVC (inferior vena cava), LMWH (low-molecular-weight heparin), PE (pulmonary embolism), UFH (unfractionated heparin)Keywords
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Article info
Publication history
Published online: March 10, 2016
Accepted:
February 11,
2016
Received in revised form:
January 21,
2016
Received:
July 30,
2015
Footnotes
☆Condensation: The 2-year recurrence rate was 3.3% in patients developing venous thromboembolism (VTE) during pregnancy or puerperium. Use of thrombolytics or inferior vena cava filter was associated with increased risk of VTE recurrence.
Identification
Copyright
© 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
