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Vienna Lancet review: Risk of relapse with venous thrombosis and pulmonary embolism

(Vienna, 15 Dec. 2010) In spring Ao. Univ. Prof. Dr. Paul Alexander Kyrle and Ao. Univ. Prof. Dr. Sabine Eichinger presented the “Vienna prediction model” and a “risk calculator” to help calculate the risk of relapse in patients with venous thrombosis or pulmonary embolism online. Now the renowned “Lancet” has published a review the two MedUni researchers were invited to submit in cooperation with Frits Rosendaal (Leiden, NL).

Patients suffering from venous thrombosis or pulmonary embolism in whom no triggering cause could be found for this occurrence have a high risk of relapse. About one third of these patients recidivate within 5 years and some 10% of patients who suffer from a relapse die of pulmonary embolism. It is therefore of major clinical interest to identify those who run a particularly high risk and would benefit from a long-term blood-thinning therapy.

In this review article different strategies for assessing the risk of relapse are presented and evaluated. Generally the risk of relapse is higher in men than in women. Clinical characteristics such as involvement of the veins in the thigh or pelvis, pulmonary embolism or the lack of a triggering cause lead to a particularly high risk of relapse. Thrombophilia screening (i.e. the search for individual biochemical or genetic risk factors such as factor V Leiden mutation), for example, has only a low predictive value for the recurrence of thromboses and should therefore not be used. Newly developed prediction models in which clinical characteristics and a global coagulation test (D-dimer) are combined promise better distinction between patients with high and low risk.

Ao. Univ. Prof. Dr. Paul Alexander Kyrle and Ao. Univ. Prof. Dr. Sabine Eichinger (both from the Division of Haematology and Haemostaseology at Department of Medicine I) are principal investigators of the Austrian Study on Recurrent Venous Thromboembolism (AUREC). With more than 1000 patients AUREC is one of the biggest prospective cohort studies in the world for examining the natural development of venous thrombosis. In AUREC many clinical and chemical laboratory risk factors for the recurrence of thromboses have been discovered including high factor VIII or the male gender. Recently the “Vienna prediction model” was developed which enables calculation of the risk of relapse with the aid of a risk calculator available on the web.

» Lancet: „Risk assessment for recurrent venous thrombosis“

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