title: Gender-related differences in the outcome of patients with venous thromboembolism and thrombophilia.
abstract: BACKGROUND
  In patients with venous thromboembolism (VTE) and factor V Leiden (FVL) or prothrombin 20210G-A mutation (PTM), the influence of gender on outcome has not been consistently studied.
  
  
  METHODS
  We used the RIETE (Registro Informatizado Enfermedad TromboEmbolica) database to assess the existence of gender differences in the rate of VTE recurrences (deep vein thrombosis [DVT] or pulmonary embolism [PE]) or major bleeding during the course of anticoagulation and after its discontinuation in FVL and PTM carriers.
  
  
  RESULTS
  From March 2001 to September 2016, 11,224 VTE patients underwent thrombophilia testing. Of these, 1,563 were FVL carriers (863 men and 700 women) and 1,231 were PTM carriers (659 men and 572 women). During the course of anticoagulant therapy, men with FVL had a 6-fold higher rate of VTE recurrences than major bleeds (31 vs. 5 events). In women with FVL, the rate of VTE recurrences was 2-fold higher (16 vs. 8), as was in men (17 vs. 8) or women (17 vs. 9) with PTM. After discontinuing anticoagulation, men with FVL had a 3-fold higher rate of DVT recurrences than women (hazard ratio [HR]: 3.13; 95% CI: 1.79-5.67), with no differences in PE recurrences. Among patients with PTM, there were no gender differences in the rate of DVT (HR: 1.89; 95% CI: 1.00-3.65) or PE recurrences (HR: 1.82; 95% CI: 0.83-4.12).
  
  
  CONCLUSIONS
  During the anticoagulation course, men with FVL are at a much higher risk for VTE recurrences than bleeding. After discontinuing anticoagulation, men with FVL are at an increased risk for DVT recurrences.
authors.affiliation: Department of Internal Medicine C, Rambam Health Care Campus, Haifa, Israel. Electronic address: i_tzoran@rambam.health.gov.il.
authors.forename: Inna
authors.initials: I
authors.lastname: Tzoran
authors.affiliation: Haematology and Hemostasis Unit, Hospital Papageorgiou, Saloniki, Greece.
authors.forename: Emmanouil
authors.initials: E
authors.lastname: Papadakis
authors.affiliation: Department of Haematology and Bone Marrow Transplantation, Rambam Health Care Campus, Haifa, Israel.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Brenner
authors.affiliation: Department of Internal Medicine, Hospital Sierrallana, Santander, Spain.
authors.forename: Reina
authors.initials: R
authors.lastname: Valle
authors.affiliation: Department of Internal Medicine, Hospital Universitario Reina Sofía, Córdoba, Spain.
authors.forename: Luciano
authors.initials: L
authors.lastname: López-Jiménez
authors.affiliation: Department of Internal Medicine, Hospital Universitari de Girona Dr Josep Trueta, Gerona, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: García-Bragado
authors.affiliation: Department of Internal Medicine, Hospital Universitario de Bellvitge - Universitat de Barcelona, Barcelona, Spain.
authors.forename: Antoni
authors.initials: A
authors.lastname: Riera-Mestre
authors.affiliation: Department of Internal Medicine, Hospital Regional Universitario de Málaga, Málaga, Spain.
authors.forename: Aurora
authors.initials: A
authors.lastname: Villalobos
authors.affiliation: Department of Medicine 3, Azienda Ospedaliera Universitaria, Parma, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Quintavalla
authors.affiliation: Department of Internal Medicine, Hospital Universitario Germans Trias i Pujol de Badalona, Barcelona, Universidad Católica de Murcia, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Monreal
mesh_terms: D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D005165:Factor V / Q000235:genetics*; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D008297:Male; D008875:Middle Aged; D020641:Polymorphism, Single Nucleotide; D011516:Prothrombin / Q000235:genetics*; D012008:Recurrence; D012737:Sex Factors; D019851:Thrombophilia / Q000188:drug therapy* / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000188:drug therapy* / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology
chemical_list: D000925:Anticoagulants; C095381:factor V Leiden; D005165:Factor V; D011516:Prothrombin
keywords: Factor V Leiden; Gender; Prothrombin 20210G-A polymorphism; Thrombophilia; Venous thromboembolism