Clinical predictors of recurrent venous thromboembolism: a single institute experience in Korea.
BACKGROUND
Racial disparities in incidence rate as well as risk factors for venous thromboembolism (VTE) exist between Asian and Western populations. Moreover, predictors for recurrent VTE were not identified in Asians. Thus, this study was undertaken to investigate risk factors for recurrent VTE events in Korean people.


METHODS
Three hundred-three patients newly diagnosed as VTE were enrolled from Seoul National University Hospital. Recurrence rate based on risk factors for VTE were investigated. Cumulative incidence of recurrent VTE was calculated by the Kaplan and Meier method. Independent predictors for VTE were determined using Cox proportional hazards model.


RESULTS
After a median follow-up of 44 months, 24 (8%) of 303 patients relapsed for a total observation time of 1,217 patient-year. Cumulative incidences of recurrent VTE were 3% at 1 year, 10% at 5 years, and 18% at 8 years. Independent predictors for recurrent VTE were presence of residual thrombosis (hazard ratio [HR]=3.1, 95% confidence interval [CI] 1.0-9.3; p=0.044), antiphospholipid syndrome (APS) (HR=4.3, 95% CI 1.0-19.0; p=0.052), and age 50 years or younger (HR=2.5, 95% CI 1.0-6.6; p=0.053) by multivariate analysis. Residual thrombosis and APS remained predictive of recurrence by the anticoagulation-period stratified analysis.


CONCLUSIONS
In contrast to Western populations, Korean patients with VTE had the lower recurrent rate. Extended anticoagulation is necessary for Korean patients with residual thrombosis or APS.
Kim
Tae Min
TM
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Kim
Jin Soo
JS
Han
Sae Won
SW
Hong
Yong Sang
YS
Kim
Inho
I
Ha
Jongwon
J
Kim
Sang Joon
SJ
Chung
Jin Wook
JW
Park
Jae Hyung
JH
Lee
Dongsoon
D
Park
Seonyang
S
Kim
Byoung Kook
BK
Kim
Noe Kyeong
NK
Yoon
Sung-Soo
SS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use; D044466:Asian People; D002648:Child; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007723:Korea / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012307:Risk Factors; D015912:Thrombolytic Therapy; D054556:Venous Thromboembolism / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D055815:Young Adult
D000925:Anticoagulants