QUALITY OF OAT AND VTE RECURRENCE
Abstract number: P-T-544
Poli1 D., Antonucci1 E., Marcucci1 R., Cellai1 A., Rogolino1 A., Attanasio1 M., Corsi1 A., Abbate1 R., Gensini2 G., Prisco1 D.
11Dept of Medical and Surgical Critical Care, Thrombosis Centre, Azienda Ospedaliero-Universitaria, Azienda Ospedaliero-Universitaria Careggi, Florence 22Dept of Medical and Surgical Critical Care, Thrombosis Centre, Azienda Ospedaliero-Universitaria, Don Carlo Gnocchi Foundation, ONLUSS IRCCS, Florence, Italy
How-to-cite Poli D, Antonucci E, Marcucci R, Cellai A, Rogolino A, Attanasio M, Corsi A, Abbate R, Gensini G, Prisco D. QUALITY OF OAT AND VTE RECURRENCE. J Thromb Haemost 2007; 5 Supplement 2: P-T-544
Abstract
Introduction: The evaluation of predictors of venous thromboembolism (VTE) recurrence at the time of oral anticoagulant treatment (OAT) withdrawal is of clinical relevance. A previous study suggests that the quality of anticoagulation is a risk factor for long-term VTE recurrence. Aim of our study was to examine if the quality of OAT in our population affects VTE recurrence
Methods: We followed-up 190 patients (109 males, 81 females) (median age 64 years (12-92) with a first episode of VTE after OAT withdrawal. Median duration of OAT was 8 (3-72) months, median follow-up period 29.5(1-114) months (551 patients/years).
Results: We recorded 32 VTE recurrences (16.8%), 23/109 males (21%) and 9/81 females (9%) after a median time of 6.5 months (1-75). Common thrombophilia was present in 18% of patients, no difference was found in the prevalence of thrombophilia between patients with and without VTE recurrence.
The time spent below the intended INR therapeutic range in patients with and without recurrence was 14.5% (1-46) vs 15% (0-63), p=0.8. Also the time spent at very low INR levels (<1.5) was similar between the 2 groups, either when we consider the first 3 months of treatment (p=0.2) or the total period (p=0.16). In addition, no difference was observed in the time spent within the therapeutic range [68% (39-85) vs 70%(13-100) respectively, p=0.3]. Interestingly, patients with recurrence spent longer time above the therapeutic range respect to patients without recurrence 14% (5-48) vs 11% (0-77), p=0.02. The mean dosage of warfarin was similar in the 2 groups (p=0.9).
Conclusions: We conclude that our data fail to identify longer period spent at very low INR levels as a risk factor for VTE recurrence but, surprisingly, show that a moderately longer time above the therapeutic range is associated to recurrence. The slight entity of this variation, if confirmed, could reflect a greater instability of anticoagulation levels in patients with recurrence
