title: Oral anticoagulation to prevent thrombosis recurrence in polycythemia vera and essential thrombocythemia.
abstract: It is unclear whether anticoagulation guidelines intended for the general population are applicable to patients with polycythemia vera (PV) and essential thrombocythemia (ET). In the present study, the risk of thrombotic recurrence was analyzed in 150 patients with PV and ET treated with vitamin K antagonists (VKA) because of an arterial or venous thrombosis. After an observation period of 963 patient-years, the incidence of re-thrombosis was 4.5 and 12 per 100 patient-years under VKA therapy and after stopping it, respectively (P < 0.0005). After a multivariate adjustment for other prognostic factors, VKA treatment was associated with a 2.8-fold reduction in the risk of thrombotic recurrence. Notably, VKA therapy offset the increased risk of re-thrombosis associated with a prior history of remote thrombosis. Both the protective effect of VKA therapy and the predisposing factors for recurrence were independent of the anatomical site involved in the index thrombosis. Treatment periods with VKA did not result in a higher incidence of major bleeding as compared with those without VKA. These findings support the use of long-term anticoagulation for the secondary prevention of thrombosis in patients with PV and ET, particularly in those with history of remote thrombosis.
authors: Hematology and Medical Oncology Department, Hospital Clínico Universitario, Avd. Blasco Ibáñez 17, 46010, Valencia, Spain, hernandez_jca@gva.es.
authors: Juan-Carlos
authors: JC
authors: Hernández-Boluda
authors: Eduardo
authors: E
authors: Arellano-Rodrigo
authors: Francisco
authors: F
authors: Cervantes
authors: Alberto
authors: A
authors: Alvarez-Larrán
authors: Montse
authors: M
authors: Gómez
authors: Pere
authors: P
authors: Barba
authors: María-Isabel
authors: MI
authors: Mata
authors: José-Ramón
authors: JR
authors: González-Porras
authors: Francisca
authors: F
authors: Ferrer-Marín
authors: Valentín
authors: V
authors: García-Gutiérrez
authors: Elena
authors: E
authors: Magro
authors: Melania
authors: M
authors: Moreno
authors: Ana
authors: A
authors: Kerguelen
authors: Manuel
authors: M
authors: Pérez-Encinas
authors: Natàlia
authors: N
authors: Estrada
authors: Rosa
authors: R
authors: Ayala
authors: Carles
authors: C
authors: Besses
authors: Arturo
authors: A
authors: Pereira
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011087:Polycythemia Vera / Q000188:drug therapy* / Q000453:epidemiology; D012008:Recurrence; D013920:Thrombocythemia, Essential / Q000188:drug therapy* / Q000453:epidemiology; D013927:Thrombosis / Q000453:epidemiology / Q000517:prevention & control*; D014812:Vitamin K / Q000037:antagonists & inhibitors
chemical_list: D000925:Anticoagulants; D014812:Vitamin K