Management of patients with venous thromboembolism and a high recurrence risk estimated by the Vienna Prediction Model: a prospective cohort study

Šinkovec, Hana (author), Kyrle, Paul A. (author), Eischer, Lisbeth (author), Gressenberger, Paul (author), Gary, Thomas (author), Brodmann, Marianne (author), Heinze, Georg (author), Eichinger, Sabine (author)

Background: The Vienna Prediction Model (VPM) identifies patients with a first unprovoked deep vein thrombosis of the leg and/or pulmonary embolism who have a low recurrence risk and may, therefore, not benefit from extended-phase anticoagulation. Objectives: The aim of this study was to evaluate patients with a predicted high risk of recurrent venous thromboembolism (VTE). Methods and Results: We prospectively followed 266 patients in whom the VPM had predicted a recurrence risk of more than 5.5% at 1 year for a median of 13.5 months. Their median age was 56 years, and 96% were men. After the VPM risk assessment, 196 patients restarted anticoagulation. While on anticoagulation, none of the patients experienced recurrent VTE, whereas 4 patients had nonmajor clinically relevant bleeding (absolute bleeding rate, 1.8 [95% CI, 0.5-4.5] events per 100 patient-years). Seventy patients were left untreated after VPM risk assessment for various reasons. Among patients not using anticoagulation, 15 had recurrence (absolute recurrence rate, 18.1 [95% CI, 10.1, 29.9] events per 100 person-years). According to the extended Kaplan–Meier analysis, the probability of VTE recurrence in patients not on anticoagulation was 10.1% and 17.9% at 6 and 12 months after VPM risk assessment, respectively. Conclusion: Anticoagulant therapy is effective and safe in patients with an unprovoked VTE, in whom the VPM had predicted a high risk of recurrent VTE. If these patients are left untreated, the risk of recurrence is high.

• Language: English
• Keywords: deep vein thrombosis, pulmonary embolism, venous thromboembolism, Vienna Prediction Model recurrence
• Work type: Article
• Typology: 1.01 - Original Scientific Article
• Organization: BF - Biotechnical Faculty
• Publication status: Published
• Publication version: Version of Record
• Year: 2025
• Number of pages: 6 str.
• Numbering: Vol. 9, iss. 1, art. 102649
• PID: 20.500.12556/RUL-166312
• UDC: 616.1
• ISSN on article: 2475-0379
• DOI: 10.1016/j.rpth.2024.102649
• COBISS.SI-ID: 221026307
• Publication date in RUL: 07.01.2025

Record is a part of a journal

• Title: Research and Practice in Thrombosis and Haemostasis
• Publisher: Wiley
• ISSN: 2475-0379
• COBISS.SI-ID: 4091820

Licences

• License: CC BY-NC-ND 4.0, Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
• Link: http://creativecommons.org/licenses/by-nc-nd/4.0/
• Description: The most restrictive Creative Commons license. This only allows people to download and share the work for no commercial gain and for no other purposes.

Secondary language

• Language: Slovenian
• Keywords: globoka venska tromboza, pljučna embolija, venska trombembolija

Projects

• Funder: FWF - Austrian Science Fund
• Project number: KLIF316