BACKGROUND: The optimal duration of anticoagulation for women who had venous thromboembolism (VTE) associated with estrogen use is unknown. OBJECTIVES: To test the hypothesis that women who had a first VTE while using estrogens have a low risk of recurrence. METHODS: A Prospective cohort study of 630 women (333 estrogen users, 297 non-users) with a first VTE, who were followed for an average of 69 months after anticoagulation withdrawal. Women with a previous or secondary VTE, coagulation inhibitor deficiency, lupus anticoagulant, cancer, pregnancy, requirement of long-term antithrombotic therapy or homozygosity or double heterozygosity for factor V Leiden and/or the G20210A prothrombin mutation were excluded. The endpoint was objectively documented symptomatic recurrent VTE. RESULTS: VTE recurred in 22 (7%) estrogen users and in 49 (17%) non-users. After 1, 2 and 5 years, the cumulative probability of recurrence was 1% (95% confidence interval [CI], 0-2), 1% (95% CI, 0-2) and 6% (95% CI, 3-9) among estrogen users and 5% (95% CI, 2-7), 9% (95% CI, 6-13) and 17% (95% CI, 12-22) among non-users. Compared with non-users, estrogen users had an adjusted relative risk (RR) of recurrent VTE of 0.4 (95% CI, 0.2-0.8). Compared with non-users in the respective age groups, the RR of recurrence was 0.4 (95% CI, 0.2-0.8) among estrogen-containing-contraceptive users and 0.7 (95% CI, 0.3-1.5) among women using estrogen-containing menopausal hormone therapy. CONCLUSIONS: Women who had their first VTE while using estrogens have a low risk of recurrent VTE. These women might not benefit from extended anticoagulant therapy.
BACKGROUND: The optimal duration of anticoagulation for women who had venous thromboembolism (VTE) associated with estrogen use is unknown. OBJECTIVES: To test the hypothesis that women who had a first VTE while using estrogens have a low risk of recurrence. METHODS: A Prospective cohort study of 630 women (333 estrogen users, 297 non-users) with a first VTE, who were followed for an average of 69 months after anticoagulation withdrawal. Women with a previous or secondary VTE, coagulation inhibitor deficiency, lupus anticoagulant, cancer, pregnancy, requirement of long-term antithrombotic therapy or homozygosity or double heterozygosity for factor V Leiden and/or the G20210A prothrombin mutation were excluded. The endpoint was objectively documented symptomatic recurrent VTE. RESULTS:VTE recurred in 22 (7%) estrogen users and in 49 (17%) non-users. After 1, 2 and 5 years, the cumulative probability of recurrence was 1% (95% confidence interval [CI], 0-2), 1% (95% CI, 0-2) and 6% (95% CI, 3-9) among estrogen users and 5% (95% CI, 2-7), 9% (95% CI, 6-13) and 17% (95% CI, 12-22) among non-users. Compared with non-users, estrogen users had an adjusted relative risk (RR) of recurrent VTE of 0.4 (95% CI, 0.2-0.8). Compared with non-users in the respective age groups, the RR of recurrence was 0.4 (95% CI, 0.2-0.8) among estrogen-containing-contraceptive users and 0.7 (95% CI, 0.3-1.5) among women using estrogen-containing menopausal hormone therapy. CONCLUSIONS:Women who had their first VTE while using estrogens have a low risk of recurrent VTE. These women might not benefit from extended anticoagulant therapy.
Authors: Michael B Streiff; Giancarlo Agnelli; Jean M Connors; Mark Crowther; Sabine Eichinger; Renato Lopes; Robert D McBane; Stephan Moll; Jack Ansell Journal: J Thromb Thrombolysis Date: 2016-01 Impact factor: 2.300
Authors: Satyajeet Roy; Han Le; Ayobamidele Balogun; Elizabeth Caskey; Thomas Tessitore; Rasagnya Kota; Janice Hejirika; Siyuan Yu; Long Nguyen; Andrew Louis Lazo; Christopher Yard; Michael Monaghan; Menaka Dhingra; Sneha Modi; Krystal Hunter Journal: J Clin Med Res Date: 2020-03-02
Authors: Hanke M G Wiegers; Jannet Knijp; Nick van Es; Michiel Coppens; Stephan Moll; Frederikus A Klok; Saskia Middeldorp Journal: J Thromb Haemost Date: 2022-02-13 Impact factor: 16.036