Family history for venous thromboembolism and the risk for recurrence

Am J Med. 2006 Jan;119(1):50-3. doi: 10.1016/j.amjmed.2005.04.043.

Abstract

Purpose: The relevance of a family history for venous thromboembolism with regard to the likelihood for recurrence is unknown.

Subjects and methods: We studied 826 patients for an average of 36 months after a first unprovoked venous thromboembolism and withdrawal of oral anticoagulation. Patients with cancer, lupus anticoagulant, or deficiency of antithrombin, protein C, or protein S were excluded. The study endpoint was objective evidence of recurrent symptomatic venous thromboembolism.

Results: Recurrence for venous thromboembolism was recorded in 23 of 190 patients (12.1%) with a family history (at least one affected first-degree family member) and in 79 of 636 patients (12.4%) without familial thrombosis (relative risk for recurrence 1.0; 95% confidence interval, 0.7-1.6; P=.9). At 5 years, the likelihood for recurrence was 20% among patients with a family history for venous thromboembolism and 18% among those without a family history for venous thromboembolism (P=.9). Risk determinants for venous thromboembolism including factor V Leiden, factor II G20210A, and high factor VIII were not statistically different between the 2 groups.

Conclusion: A family history for venous thromboembolism does not segregate patients into high- or low-risk categories and is not suitable to identify patients at increased risk for recurrent venous thromboembolism.

MeSH terms

  • Anticoagulants / therapeutic use
  • Factor VIII / analysis
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prothrombin / analysis
  • Pulmonary Embolism / blood
  • Pulmonary Embolism / genetics*
  • Pulmonary Embolism / prevention & control
  • Recurrence
  • Risk Factors
  • Venous Thrombosis / blood
  • Venous Thrombosis / genetics*
  • Venous Thrombosis / prevention & control

Substances

  • Anticoagulants
  • Prothrombin
  • Factor VIII