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Vol. 216. Issue 9.
Pages 488-494 (December 2016)
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Vol. 216. Issue 9.
Pages 488-494 (December 2016)
Review
Recurrence risk of idiopathic venous thromboembolism
Riesgo de recurrencia en el tromboembolismo venoso idiopático
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A.I. Franco-Morenoa,
Corresponding author
aifranco@torrejonsalud.com

Corresponding author.
, C.L. de Ancos-Aracilb, M.J. García-Navarroa
a Medicina Interna, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, Spain
b Medicina Interna, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain
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Tables (4)
Table 1. Risk factors for recurrence in unprovoked venous thromboembolism disease.7–12,16,23,24,31,32,40–42
Table 2. MEN continue and HER DOO2 model (gender, HER, d-dimer, obesity, older age).27
Table 3. Vienna prediction model.21
Table 4. DASH score (d-dimer, age, sex, hormonal therapy).22
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Abstract

For patients with idiopathic venous thromboembolism (unprovoked), the risk of recurrence is high. Secondary prophylaxis with anticoagulant therapy reduces the thrombotic risk but at the expense of an increased risk of hemorrhage. A number of factors, such as the male sex and an increase in dimer-d concentrations after completing the anticoagulation therapy, are associated with an increased risk of recurrence. Other factors such as residual venous thrombosis have a more controversial and sometimes contradictory relationship. A number of models have been proposed for predicting thrombotic recurrence risk after anticoagulation therapy in unprovoked venous thromboembolism. However, these models need external validation to determine their current usefulness in clinical practice. In this article, we analyze the risk factors for thrombotic recurrence and the existing prediction models.

Keywords:
Venous thromboembolism disease
Recurrence
Risk factor
Clinical prediction
Resumen

En pacientes con enfermedad tromboembólica venosa idiopática (no provocada) el riesgo de recurrencia es elevado. La profilaxis secundaria con terapia anticoagulante reduce el riesgo trombótico, pero a expensas de un incremento del riesgo de hemorragias. Algunos factores, como el sexo masculino o una elevación de la concentración de dímero-D tras finalizar la anticoagulación, se asocian a un mayor riesgo de recidiva; otros, como la trombosis venosa residual, tienen una relación más controvertida, incluso contradictoria. Se han propuesto algunos modelos de predicción del riesgo de recurrencia trombótica tras la anticoagulación en la enfermedad tromboembólica venosa (ETEV) no provocado, pero necesitan una validación externa para conocer su utilidad real en la práctica clínica. En este artículo se analizan los factores de riesgo de recidiva trombótica y los modelos de predicción existentes.

Palabras clave:
Enfermedad tromboembólica venosa
Recurrencia
Factor de riesgo
Predicción clínica

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