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Previous Volume 350:2558-2563 June 17, 2004 Number 25 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Editorial by Elliott, C. G. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

ABSTRACT

Background Whether a patient's sex is associated with the risk of recurrent venous thromboembolism is unknown.

Methods We studied 826 patients for an average of 36 months after a first episode of spontaneous venous thromboembolism and the withdrawal of oral anticoagulants. We excluded pregnant patients and patients with a deficiency of antithrombin, protein C, or protein S; the lupus anticoagulant; cancer; or a requirement for potentially long-term antithrombotic treatment. The end point was objective evidence of a recurrence of symptomatic venous thromboembolism.

Results Venous thromboembolism recurred in 74 of the 373 men, as compared with 28 of the 453 women (20 percent vs. 6 percent; relative risk of recurrence, 3.6; 95 percent confidence interval, 2.3 to 5.5; P<0.001). The risk remained unchanged after adjustment for age, the duration of anticoagulation, and the presence or absence of a first symptomatic pulmonary embolism, factor V Leiden, factor II G20210A, or an elevated level of factor VIII or IX. At five years, the likelihood of recurrence was 30.7 percent among men, as compared with 8.5 percent among women (P<0.001). The relative risk of recurrence was similar among women who had had their first thrombosis during oral-contraceptive use or hormone-replacement therapy and women in the same age group in whom the first event was idiopathic.

Conclusions The risk of recurrent venous thromboembolism is higher among men than women.

Source Information

From the Department of Internal Medicine I, Division of Hematology and Hemostasis (P.A.K., A.W., S.E.), Ludwig Boltzmann-Institut für Thromboseforschung (P.A.K.), and the Department of Internal Medicine II, Division of Angiology, Medical University of Vienna (E.M.); Wilhelminenspital (C.B.); and Hanusch Krankenhaus (M.H.) — all in Vienna.

Address reprint requests to Dr. Kyrle at the Department of Internal Medicine I, Division of Hematology and Hemostasis, Währinger Gürtel 18-20, A 1090 Vienna, Austria, or at paul.kyrle{at}meduniwien.ac.at.

Full Text of this Article

Related Letters:

Recurrent Venous Thromboembolism in Men and Women
Agnelli G., Becattini C., Prandoni P., Nieto J. A., Monreal M., the RIETE Investigators , Kahn S. R., Boari B., Salmi R., Manfredini R., Morita H., Nagai R., Ross D. J., Kyrle P. A., Eichinger S., Weltermann A.
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N Engl J Med 2004; 351:2015-2018, Nov 4, 2004. Correspondence

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