Why the study?
Evaluating VTE recurrence risk with strategies including D-dimer testing after discontinuing anticoagulation raises concern about early recurrence.
Does stopping anticoagulation increase symptomatic VTE within 30 days in adult noncancer patients with deep vein thrombosis of the leg and/or pulmonary embolism treated with anticoagulants for ≥3 months?
Does stopping anticoagulation increase symptomatic VTE within 30 days in adult noncancer patients with deep vein thrombosis of the leg and/or pulmonary embolism treated with anticoagulants for ≥3 months?
The incidence of early VTE recurrence within 30 days after stopping anticoagulation is low, suggesting that temporarily discontinuing therapy to assess recurrence risk is safe.
Background: Patients with venous thromboembolism (VTE) receive anticoagulation for at least 3 months. To evaluate recurrence risk thereafter, some strategies include D-dimer testing after discontinuing anticoagulation, which raises concern about early recurrence. Objectives: To assess the incidence of recurrent VTE within 30 days after stopping anticoagulation. Methods: We conducted a systematic review of EMBASE, CENTRAL, and MEDLINE to identify controlled trials and cohort studies of adult noncancer patients with deep vein thrombosis of the leg and/or pulmonary embolism treated with anticoagulants for ≥3 months. The primary outcome was symptomatic VTE within 30 days. The risk of bias was assessed using a modified version of the Newcastle-Ottawa Scale. Pooled recurrence rates were calculated using fixed random-effects meta-analyses. Results: = .1). Findings regarding age were inconsistent. None of the recurrences was fatal. The overall risk of bias was low. Conclusion: The incidence of early VTE recurrence after stopping anticoagulation is low. Temporarily discontinuing therapy to assess recurrence risk, therefore, appears safe and may aid in guiding treatment duration.
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Eischer et al. (2025) studied this question.
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