VTE recurrence

The risk of recurrence after a first VTE is substantial, as up to 30-40% of the patients experience a recurrence within 10 years following the first event. Both first and recurrent events can be effectively prevented with anticoagulants, although at the cost of increased bleeding risk. The challenge therefore lies in identifying patients who may benefit from thromboprophylaxis, but with minimal risk of bleeding complications.

Risk factors and biomarkers for VTE recurrence

Identification of biomarkers for first and recurrent VTE are needed to improve risk stratification and guide decisions on initiation and duration of anticoagulant treatment. In this project, we investigate risk factors and biomarkers for VTE recurrence using data from VTE cohorts (mainly the Tromsø study). We are also members of a collaborative project on prediction of VTE (VTE-predict).

Principal Investigator: John-Bjarne Hansen

External Collaborators: Maria de Winter and Mathilde Nijkeuter (University Medical Center Utrecht), Suzanne C. Cannegieter (Leiden University Medical Center)

D-dimer at VTE diagnosis and risk of recurrent VTE

In this project, we aim to explore the utility of D-dimer measured at the time of diagnosis as a risk factor for recurrent VTE. We will use data from the Tromsø study and the TROLL registry of VTE patients at Østfold Hospital. We will investigate whether D-dimer measured at the time of the first VTE diagnosis can be used to assess risk of recurrent VTE, and whether D-dimer at time of diagnosis can be utilized in currently available risk prediction models of VTE recurrence.

External collaborators: Waleed Ghanima (Østfold Hospital, University of Oslo)

Publications:

Rinde et al. Low D-dimer levels at diagnosis of venous thromboembolism are associated with reduced risk of recurrence: data from the TROLL registry. J Thromb Haemost. 2023;21:1861-8.

de Winter et al. Recurrent venous thromboembolism and bleeding with extended anticoagulation: the VTE-PREDICT risk score. Eur Heart J. 2023;44:1231-44.

de Winter et al. Redefining clinical venous thromboembolism phenotypes: a novel approach using latent class analysis. J Thromb Haemost. 2023;21:573-85.

Leknessund et al. Hand grip strength in venous thromboembolism: risk of recurrence and mortality. Res Pract Thromb Haemost. 2023;7:102138.

Timp et al. Prediction of recurrent venous thrombosis in all patients with a first venous thrombotic event: The Leiden Thrombosis Recurrence Risk Prediction model (L-TRRiP). PLoS Med. 2019;16:e1002883.

Isaksen et al. Dietary Intake of Marine Polyunsaturated n-3 Fatty Acids and Risk of Recurrent Venous Thromboembolism. Thromb Haemost. 2019;119:2053-63.

Evensen et al. Physical activity and risk of recurrence and mortality after incident venous thromboembolism. J Thromb Haemost. 2019;17:901-11.

Gran et al. Occult cancer-related first venous thromboembolism is associated with an increased risk of recurrent venous thromboembolism. J Thromb Haemost. 2017;15:1361-7.

Bjori et al. D-dimer at venous thrombosis diagnosis is associated with risk of recurrence. J Thromb Haemost. 2017;15:917-24.

Bjori et al. Hospital-related first venous thromboembolism and risk of recurrence. J Thromb Haemost. 2016;14:2368-75.

Members:

John Bjarne Hansen

Sigrid Kufaas Brækkan

Financial/grant information:

North Norwegian Health Authority (Helse Nord)