title: Long-term prospective study of recurrent venous thromboembolism in a Hispanic population.
abstract: The aim of this study was to assess the incidence and risk factors for recurrent venous thromboembolism (VTE) in a Hispanic population. We prospectively followed 343 patients after a first episode of objectively proven VTE. We excluded all patients with VTE at unusual sites, older than 70 years old, with neoplasia, liver or renal chronic disease and antiphospholipid syndrome. Predictors for recurrence were evaluated by Cox model. The probability of recurrent VTE was estimated by the method of Kaplan-Meier. The cumulative probability of recurrent VTE was 19.1% in 5 years and 30.0% in 10 years. Male sex [relative risk (RR) 1.7, 95% confidence interval (CI) 1.0-2.8], spontaneous first VTE (RR 2.9, 95% CI 1.7-5.0) and FII G20210A mutation (RR 4.2, 95% CI 1.9-9.4) were independent risk factors for recurrent VTE. The fibrinogen, coagulation factors VIII, IX, X and XI were measured in 200 patients and were not associated to thrombotic recurrence risk. This study indicates that the incidence of recurrent VTE is high in Hispanics and depends on clinical and laboratory findings. In this population, FII G20210A mutation may represent a specific risk factor for recurrence. The inclusion of different ethnic populations in epidemiological studies of VTE as well as new approaches to the management of anticoagulation therapy in Hispanics is warranted.
authors.affiliation: Hematology and Hemotherapy Center, State University of Campinas, Campinas, Sao Paulo, Brazil. tayana.mello@uol.com.br
authors.forename: Tayana B T
authors.initials: TB
authors.lastname: Mello
authors.forename: Fernanda L A
authors.initials: FL
authors.lastname: Orsi
authors.forename: Silmara A L
authors.initials: SA
authors.lastname: Montalvao
authors.forename: Margareth C
authors.initials: MC
authors.lastname: Ozelo
authors.forename: Erich V
authors.initials: EV
authors.lastname: de Paula
authors.forename: Joyce M
authors.initials: JM
authors.lastname: Annichinno-Bizzachi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001779:Blood Coagulation Factors / Q000032:analysis; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011336:Probability; D011446:Prospective Studies; D011516:Prothrombin / Q000235:genetics; D012008:Recurrence; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D054556:Venous Thromboembolism / Q000453:epidemiology / Q000208:ethnology*; D055815:Young Adult
chemical_list: D001779:Blood Coagulation Factors; D011516:Prothrombin