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lüll Venous thromboembolism: risk factors for recurrence Zhu T; Martinez I; Emmerich JArterioscler Thromb Vasc Biol 2009[Mar]; 29 (3): 298-310Patients who have a first episode of venous thromboembolism (VTE) have an elevated risk of a recurrent episode, and this necessitates secondary prophylaxis. Anticoagulant therapy is a double-edged sword, however, as it reduces the risk of recurrent VTE but increases the risk of hemorrhage. This balance must be taken into account when assessing the risk-benefit ratio of long-term anticoagulation. Some clinical characteristics of the index VTE event can help to categorize the individual risk of recurrence. Patients with persistent risk factors such as cancer have a significantly higher risk of recurrent thrombosis. In contrast, VTE provoked by transient risk factors is associated with a lower risk of recurrence. Intrinsic features of patients with VTE (gender, age, hereditary thrombophilia) have also been linked to the risk of recurrent VTE. There is increasing evidence that a normal D-dimer level and the absence of residual venous thrombosis after discontinuation of oral anticoagulation are associated with a lower risk of recurrent VTE events. Future studies are needed to refine the predictive value of known risk factors for VTE recurrence and to discover better markers.|Administration, Oral[MESH]|Age Factors[MESH]|Anticoagulants/administration & dosage/adverse effects/*therapeutic use[MESH]|Antiphospholipid Syndrome/complications[MESH]|Biomarkers/blood[MESH]|Drug Administration Schedule[MESH]|Female[MESH]|Fibrin Fibrinogen Degradation Products/metabolism[MESH]|Hemorrhage/chemically induced[MESH]|Humans[MESH]|Male[MESH]|Neoplasms/complications[MESH]|Predictive Value of Tests[MESH]|Pulmonary Embolism/blood/drug therapy/ethnology/*etiology[MESH]|Risk Assessment[MESH]|Risk Factors[MESH]|Secondary Prevention[MESH]|Sex Factors[MESH]|Thrombin/metabolism[MESH]|Thrombophilia/complications[MESH]|Treatment Outcome[MESH]|Venous Thromboembolism/blood/drug therapy/ethnology/*etiology[MESH]|Venous Thrombosis/blood/drug therapy/ethnology/*etiology[MESH] |