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Prediction of recurrent venous thromboembolism by the activated partial thromboplastin time
Author(s) -
HRON G.,
EICHINGER S.,
WELTERMANN A.,
QUEHENBERGER P.,
HALBMAYER W. M.,
KYRLE P. A.
Publication year - 2006
Publication title -
journal of thrombosis and haemostasis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.947
H-Index - 178
eISSN - 1538-7836
pISSN - 1538-7933
DOI - 10.1111/j.1538-7836.2006.01868.x
Subject(s) - medicine , partial thromboplastin time , discontinuation , venous thromboembolism , gastroenterology , thrombophilia , risk factor , coagulation testing , clinical endpoint , odds ratio , coagulation , surgery , thrombosis , randomized controlled trial
Summary. Background: Venous thromboembolism (VTE) is a multi‐factorial disease. Extensive thrombophilia screening is costly and often inconclusive. Simple laboratory methods are required to predict the risk of recurrence. Objective: To assess if measurement of activated partial thromboplastin time (APTT) allows stratification of patients with VTE into high‐ and low‐risk categories with regard to recurrence. Patients and methods: We prospectively followed 918 patients with a first unprovoked VTE and studied the relationship between recurrence and an APTT after discontinuation of anticoagulation. APTT was expressed as a ratio of test to reference coagulation times. Study endpoint was symptomatic recurrent VTE. Results: Venous thromboembolism recurred in 101 (11%) patients. Patients without recurrence had a greater APTT ratio than those with recurrence (0.97 ± 0.09 vs. 0.93 ± 0.09, P = 0.001). After 4 years, probability of recurrent VTE was 8.5% (95% CI: 5.5–11.5%) among patients with a ratio equal to or > 0.95 and 15.6% (95% CI: 11.4–19.9%) among patients with a lower ratio ( P = 0.005). Compared with patients with an APTT ratio < 0.95, the relative risk (RR) of recurrence among patients with a ratio equal to or > 0.95 was 0.56 (95% CI: 0.38–0.84, P = 0.005) before and 0.58 (95% CI: 0.39–0.87, P = 0.009) after adjustment for sex, age, factor V Leiden, and factor II G20210A. Conclusions: Measurement of APTT allows stratification of patients with VTE into high‐ and low‐risk categories with regard to recurrence.