Long-Term Risk for Recurrent VTE Significant After Stopping Anticoagulation

By Kelly Young

Edited by André Sofair, MD, MPH, and William E. Chavey, MD, MS

Over a third of patients with an initial unprovoked venous thromboembolism (VTE) who discontinue anticoagulation could experience a recurrence over the next decade, according to a meta-analysis in The BMJ.

Researchers analyzed 18 studies with 7500 patients with unprovoked VTE who discontinued anticoagulation after at least 3 months.

In the first year after treatment discontinuation, the recurrence risk was 10%, reaching a cumulative risk of 16% at 2 years, 25% at 5 years, and 36% by 10 years. Risk of recurrence after distal deep vein thrombosis was lower (1.9% after 1 year). Men had higher recurrence risk than women. Nearly 4% of recurrent events were fatal.

The authors conclude: "These findings provide rigorous benchmarks of the long term risks and consequences of recurrent VTE that should inform clinical practice guidelines, enhance confidence in counselling patients of their prognosis, and help guide decision making about long term management of unprovoked VTE."