Can thrombophilia testing impact clinical decision to extend anticoagulation following deep venous thrombosis? A Bulgarian cohort

BACKGROUND: Aim of our study was to evaluate whether D-dimer testing and genetic analysis for hereditary thrombophilia could assist in deciding on long-term treatment in DVT patients.METHODS: The prospective observational snapshot survey included 200 consecutive patients with first unprovoked DVT. Data about risk factors, D-dimer testing and genetic analysis for hereditary thrombophilia, and results from Duplex ultrasound exam were used to support the decision to extend anticoagulation.RESULTS: Risk factors for DVT were found in 75% of patients and comorbidity in 44.5%. Ultrasound examination established 55% average vein recanalization. Genetic analysis reported that 52.5% of patients were carriers of one mutation, 32.5% of two mutations and 2% of three mutations. 46% of patients were treated with low-molecular weight heparin, followed by oral anticoagulation and 54% with direct oral anticoagulants. The results revealed that the decision about therapy depended on several factors (P<0.05): D-dimer, HERDOO2 score, patient complaints, clinical status and treatment, but was unrestrained from the genetic analysis results (P=0.56).CONCLUSIONS: The presence of thrombophilia is only one of the risk factors for VTE recurrence. The results from thrombophilia testing should by no means be the leading factor in the clinical decision regarding extended anticoagulation following DVT.