April 10, 2006Archives of Internal Medicine
Risk of Recurrent Venous Thromboembolism in Patients With Common Thrombophilia
Key result
Heterozygous factor V Leiden and prothrombin G20210A polymorphisms were associated with modestly increased odds of recurrent VTE (OR 1.41 and OR 1.72, respectively) after a first event.
Why the study?
Does the presence of heterozygous factor V Leiden or prothrombin G20210A polymorphism increase the risk of recurrent VTE in patients with a first episode of VTE?
Population
13 cohort studies pooling patients with a first episode of venous thromboembolism following discontinuation…
Comparison
Presence of heterozygous factor V Leiden or… vs Absence of heterozygous factor V Leiden or…
Design
Meta-analysis
Authors
Discussion
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Implication
Does not justify extended anticoagulation or routine testing; confirms modest association but leaves personalized duration decisions open.
Study Design
Type
Meta-Analysis (n=3,104)
Structured PICO
Does the presence of heterozygous factor V Leiden or prothrombin G20210A polymorphism increase the risk of recurrent VTE in patients with a first episode of VTE?
P
Population
13 cohort studies pooling patients with a first episode of venous thromboembolism (VTE) following discontinuation of anticoagulation. FVL analysis included 10 studies (n=3104) and prothrombin G20210A analysis included 9 studies (n=2903).
I
Intervention
Presence of heterozygous factor V Leiden (FVL) or prothrombin G20210A polymorphism
C
Comparator
Absence of heterozygous factor V Leiden (FVL) or prothrombin G20210A polymorphism
O
Outcome
Incidence of objectively confirmed recurrent VTE following discontinuation of anticoagulationhard clinical
Main Result
Effect estimate: OR 1.41 (FVL), OR 1.72 (prothrombin G20210A) (95% CI 1.14-1.75 (FVL), 1.27-2.31 (prothrombin G20210A))
Heterozygous FVL and prothrombin G20210A modestly increase the risk of recurrent VTE, but the magnitude does not justify extended-duration anticoagulation or routine testing.
Cite This Study
Ho et al. (2006) conducted a meta-analysis in First episode of venous thromboembolism (VTE) (n=3,104). Heterozygous factor V Leiden (FVL) or prothrombin G20210A polymorphism vs. Without heterozygous FVL or prothrombin G20210A polymorphism was evaluated on Recurrent VTE (OR 1.41 (FVL), OR 1.72 (prothrombin G20210A), 95% CI 1.14-1.75 (FVL), 1.27-2.31 (prothrombin G20210A)). Heterozygous factor V Leiden and prothrombin G20210A polymorphisms were associated with modestly increased odds of recurrent VTE (OR 1.41 and OR 1.72, respectively) after a first event.