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Age over 75 does not increase the risk of recurrent venous thromboembolism: Findings from the RIETE registry

Published:December 16, 2022DOI:https://doi.org/10.1016/j.thromres.2022.12.005
Age over 75 does not increase the risk of recurrent venous thromboembolism: Findings from the RIETE registry
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      Based on current evidence, in most patients with an episode of venous thromboembolism (VTE) extended anticoagulation is generally recommended beyond the initial 3–6 months provided the bleeding risk is acceptably low [
      • Weitz J.I.
      • Prandoni P.
      • Verhamme P.
      Anticoagulation for patients with venous thromboembolism: when is extended treatment required?.
      Thromb. Haemost. Open. 2020; 4: e446-e456
      ]. Among factors that are expected to increase the risk of (major) bleeding complications is the elderly age. In a recent overview and meta-analysis of 27 prospective cohort and randomized clinical trials, older patients were found to exhibit a higher risk of major or clinically relevant bleeding complications, even with the use of the direct oral anticoagulants (DOAC) [
      • Khan F.
      • Tritschler T.
      • Kimpton M.
      • Wells P.S.
      • Kearon C.
      • Weitz J.I.
      • Büller H.R.
      • Raskob G.E.
      • Ageno W.
      • Couturaud F.
      • Prandoni P.
      • Palareti G.
      • Legnani C.
      • Kyrle P.A.
      • Eichinger S.
      • Eischer L.
      • Becattini C.
      • Agnelli G.
      • Vedovati M.C.
      • Geersing G.J.
      • Takada T.
      • Cosmi B.
      • Aujesky D.
      • Marconi L.
      • Palla A.
      • Siragusa S.
      • Bradbury C.A.
      • Parpia S.
      • Mallick R.
      • Lensing A.W.A.
      • Gebel M.
      • Grosso M.A.
      • Thavorn K.
      • Hutton B.
      • Le Gal G.
      • Fergusson D.A.
      • Rodger M.A.
      Long-term risk for major bleeding during extended oral anticoagulant therapy for first unprovoked venous thromboembolism: a systematic review and meta-analysis.
      Ann. Intern. Med. 2021; 174: 1420-1429
      ]. Not surprisingly, therefore, the prolongation of anticoagulation beyond the initial 3–6 months in patients over 75 years old is generally discouraged [
      • Kearon C.
      • Akl E.A.
      • Ornelas J.
      • Blaivas A.
      • Jimenez D.
      • Bounameaux H.
      • Huisman M.
      • King C.S.
      • Morris T.A.
      • Sood N.
      • Stevens S.M.
      • Vintch J.R.
      • Wells P.
      • Woller S.C.
      • Moores L.
      Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report.
      Chest. 2016; 149: 315-352
      ]. This recommendation, however, can only be justified if the risk of recurrent VTE in patients in whom anticoagulation is discontinued does not exceed that expected in younger individuals. As far as we know, no study has addressed the risk of recurrent VTE beyond the age of 75. Hence, this key question is still unanswered.

      Keywords

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      References

        • Weitz J.I.
        • Prandoni P.
        • Verhamme P.
        Anticoagulation for patients with venous thromboembolism: when is extended treatment required?.
        Thromb. Haemost. Open. 2020; 4: e446-e456
        View in Article
        • Khan F.
        • Tritschler T.
        • Kimpton M.
        • Wells P.S.
        • Kearon C.
        • Weitz J.I.
        • Büller H.R.
        • Raskob G.E.
        • Ageno W.
        • Couturaud F.
        • Prandoni P.
        • Palareti G.
        • Legnani C.
        • Kyrle P.A.
        • Eichinger S.
        • Eischer L.
        • Becattini C.
        • Agnelli G.
        • Vedovati M.C.
        • Geersing G.J.
        • Takada T.
        • Cosmi B.
        • Aujesky D.
        • Marconi L.
        • Palla A.
        • Siragusa S.
        • Bradbury C.A.
        • Parpia S.
        • Mallick R.
        • Lensing A.W.A.
        • Gebel M.
        • Grosso M.A.
        • Thavorn K.
        • Hutton B.
        • Le Gal G.
        • Fergusson D.A.
        • Rodger M.A.
        Long-term risk for major bleeding during extended oral anticoagulant therapy for first unprovoked venous thromboembolism: a systematic review and meta-analysis.
        Ann. Intern. Med. 2021; 174: 1420-1429
        View in Article
        • Kearon C.
        • Akl E.A.
        • Ornelas J.
        • Blaivas A.
        • Jimenez D.
        • Bounameaux H.
        • Huisman M.
        • King C.S.
        • Morris T.A.
        • Sood N.
        • Stevens S.M.
        • Vintch J.R.
        • Wells P.
        • Woller S.C.
        • Moores L.
        Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report.
        Chest. 2016; 149: 315-352
        View in Article
        • Bikdeli B.
        • Jimenez D.
        • Hawkins M.
        • Ortíz S.
        • Prandoni P.
        • Brenner B.
        • Decousus H.
        • Masoudi F.A.
        • Trujillo-Santos J.
        • Krumholz H.M.
        • Monreal M.
        Rationale, design and methodology of the computerized registry of patients with venous thromboembolism.
        Thromb. Haemost. 2018; 118: 214-224
        View in Article
        • Heit J.A.
        Venous thromboembolism: disease burden, outcomes and risk factors.
        J. Thromb. Haemost. 2005; 3: 1611-1617
        View in Article
        • Lauber S.
        • Limacher A.
        • Tritschler T.
        • Stalder O.
        • Méan M.
        • Righini M.
        • Aschwanden M.
        • Hans Beer J.
        • Frauchiger B.
        • Osterwalder J.
        • Kucher N.
        • Lämmle B.
        • Cornuz J.
        • Angelillo-Scherrer A.
        • Matter C.M.
        • Husmann M.
        • Banyai M.
        • Staub D.
        • Mazzolai L.
        • Hugli O.
        • Rodondi N.
        • Aujesky D.
        Predictors and outcomes of recurrent venous thromboembolism in elderly patients.
        Am. J. Med. 2018; 131: e7-703.e16
        View in Article
        • Campello E.
        • Simioni P.
        • Prandoni P.
        • Ferri N.
        Clinical pharmacology of factor XI inhibitors: new therapeutic approaches for prevention of venous and arterial thrombotic disorders.
        J. Clin. Med. 2022; 11: 6314
        View in Article
        • Andreozzi G.M.
        • Bignamini A.A.
        • Davì G.
        • Palareti G.
        • Matuška J.
        • Holý M.
        • Pawlaczyk-Gabriel K.
        • Džupina A.
        • Sokurenko G.Y.
        • Didenko Y.P.
        • Andrei L.D.
        • Lessiani G.
        • Visonà A.
        Sulodexide for the Prevention of Recurrent Venous Thromboembolism: The Sulodexide in secondary prevention of recurrent deep vein thrombosis (SURVET) study: a multicenter, randomized, double-blind, placebo-controlled trial.
        Circulation. 2015; 132: 1891-1897
        View in Article
        • Palareti G.
        • Legnani C.
        • Antonucci E.
        • Zorzi S.
        • Bignamini A.A.
        • Lodigiani C.
        • Tosetto A.
        • Bertù L.
        • Pengo V.
        • Testa S.
        • Ageno W.
        • Prisco D.
        • Prandoni P.
        • Poli D.
        Design and rationale of a randomized, placebo-controlled trial on the efficacy and safety of sulodexide for extended treatment in elderly patients after a first venous thromboembolism.
        Intern.Emerg. Med. 2021; 16: 359-368
        View in Article

      Article info

      Publication history

      Published online: December 16, 2022
      Accepted: December 12, 2022
      Received in revised form: December 1, 2022
      Received: October 29, 2022

      Identification

      DOI: https://doi.org/10.1016/j.thromres.2022.12.005

      Copyright

      © 2022 Elsevier Ltd. All rights reserved.

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