title: [Risk factors for recurrent venous thromboembolism].
abstract: Recurrent venous thromboembolism (VTE) is frequent and can be fatal. Long-term antithrombotic treatment reduces the risk of recurrent VTE but increases the risk of bleeding and, therefore, cannot be proposed for all patients. Predicting the probability of recurrence in an individual patient is of utmost importance for assessing the risk-benefit ratio of long-term anticoagulation. Multiple clinical risk factors for recurrent VTE have been identified which include: unprovoked first episode, anatomical proximal location, male gender, residual venous thrombosis, cancer and antiphospholipid syndrome. d-dimer level after discontinuation of oral anticoagulation can help to predict the risk of recurrence with a good negative predictive value. Finally, genetic polymorphisms and rare inherited deficiencies of natural anticoagulant proteins do not seem to be strongly associated to recurrence. New antithrombotic drugs may, in the near future, improve the safety and of long-term anticoagulation treatment.
authors.affiliation: Unité Inserm U765, université Paris Descartes, faculté de médecine, 75508 Paris cedex, France.
authors.forename: J
authors.initials: J
authors.lastname: Rosencher
authors.forename: T
authors.initials: T
authors.lastname: Mirault
authors.forename: I
authors.initials: I
authors.lastname: Martinez
authors.forename: T
authors.initials: T
authors.lastname: Zhu
authors.forename: E
authors.initials: E
authors.lastname: Messas
authors.forename: J
authors.initials: J
authors.lastname: Emmerich
mesh_terms: D000367:Age Factors; D016736:Antiphospholipid Syndrome / Q000097:blood / Q000150:complications; D001779:Blood Coagulation Factors / Q000235:genetics; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000627:therapeutic use; D006470:Hemorrhage / Q000097:blood / Q000139:chemically induced; D006495:Heparin, Low-Molecular-Weight / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D008134:Long-Term Care; D009369:Neoplasms / Q000097:blood / Q000150:complications; D009360:Neoplastic Cells, Circulating; D011110:Polymorphism, Genetic; D011655:Pulmonary Embolism / Q000097:blood / Q000209:etiology; D012008:Recurrence; D012307:Risk Factors; D012737:Sex Factors; D013917:Thrombin / Q000378:metabolism; D054556:Venous Thromboembolism / Q000097:blood / Q000209:etiology*
chemical_list: D001779:Blood Coagulation Factors; D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight; D013917:Thrombin