title: Outcome after discontinuing anticoagulant therapy in women with venous thromboembolism during hormonal use.
abstract: BACKGROUND
  Whether women developing venous thromboembolism (VTE) while using hormonal therapy should be classified as having "unprovoked" or "provoked" VTE is controversial.
  
  
  METHODS
  We used the RIETE (Registro Informatizado Enfermedad TromboEmbólica) database to compare the rate of symptomatic VTE recurrences after discontinuing anticoagulation in 3 subgroups of women aged ≤50years without cancer, pregnancy or puerperium: (1) those with hormonal therapy and no additional risk factors (hormonal users only); (2) those with unprovoked VTE; and (3) those with additional risk factors, with or without hormonal therapy.
  
  
  RESULTS
  As of March 2016, 1513 women had been followed-up for at least one month after discontinuing anticoagulation. Of these, 654 (43%) were hormonal users only, 390 (26%) had unprovoked VTE and 469 (31%) had transient risk factors with or without hormonal therapy. After discontinuing anticoagulation, the rate of VTE recurrences in women with hormonal use only (2.44 per 100 patient-years; 95% CI: 1.53-3.69) was significantly lower than in those with unprovoked VTE (6.03; 95% CI: 3.97-8.77) and similar to those with transient risk factors (2.58; 95% CI: 1.50-4.13). Interestingly, the rate of VTE recurrences presenting as pulmonary embolism in women with hormonal use only (0.55 per 100 patient-years; 95% CI: 0.18-1.29) was similar to those with transient risk factors (0.46; 95% CI: 0.09-1.33) and 4-fold lower than in women with unprovoked VTE (2.23; 95% CI: 1.07-4.10).
  
  
  CONCLUSIONS
  After discontinuing anticoagulation, the rate of VTE recurrences in hormonal users only was significantly lower than in women with unprovoked VTE and similar to the rate in women with additional risk factors.
authors.affiliation: Department of Internal Medicine, Hospital Universitario Reina Sofía, Córdoba, Spain.
authors.forename: Ángeles
authors.initials: Á
authors.lastname: Blanco-Molina
authors.affiliation: Department of Internal Medicine, Hospital General Universitario Santa Lucía, Murcia, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Trujillo-Santos
authors.affiliation: Department of Medicine - DIMED, 2nd Chair of Internal Medicine, University of Padua, Padua, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Pesavento
authors.affiliation: Department of Internal Medicine, Hospital Universitario Virgen de Arrixaca, Murcia, Spain.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Rosa
authors.affiliation: Department of Internal Medicine, Consorci Hospitalari de Mataró, Barcelona, Spain.
authors.forename: Conxita
authors.initials: C
authors.lastname: Falgá
authors.affiliation: Department of Internal Medicine, Corporación Sanitaria Parc Taulí, Barcelona, Spain.
authors.forename: Carles
authors.initials: C
authors.lastname: Tolosa
authors.affiliation: Department of Angiology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
authors.forename: Lucia
authors.initials: L
authors.lastname: Mazzolai
authors.affiliation: Department of Internal Medicine, Hospital Reina Sofía, Tudela, Navarra, Spain.
authors.forename: Ángel
authors.initials: Á
authors.lastname: Sampériz
authors.affiliation: Department of Laboratory of Analysis, Ospedale Galliera, Genoa, Italy.
authors.forename: Rita
authors.initials: R
authors.lastname: Duce
authors.affiliation: Department of Internal Medicine, Hospital Universitario Germans Trias i Pujol de Badalona, Universidad Católica de Murcia, Spain. Electronic address: mmonreal.germanstrias@gencat.cat.
authors.forename: Manuel
authors.initials: M
authors.lastname: Monreal
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D020249:Hormone Replacement Therapy; D006801:Humans; D008875:Middle Aged; D012008:Recurrence; D012307:Risk Factors; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology
chemical_list: D000925:Anticoagulants
keywords: Hormonal therapy; Recurrences; Venous thromboembolism; Women