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Predicting Who Is Vulnerable for Recurrent Blood Clots Getting Closer - The Answer is in Protein Thrombin Generation - Venous Thrombosis 

July 29th 2006

Predicting Who Is Vulnerable for Recurrent Blood Clots Getting Closer - The Answer is in Protein Thrombin Generation - Venous Thrombosis

Blood Clot

Australian researchers say that men who have had blood clots have a 50% higher risk of getting more of them compared to women after finishing their anti-clotting treatments.  There is no difference in risk for men and women getting a blood clot for the first time, but the research may help in determining how long patients should be treated for deep venous thrombosis. 

Researchers are still not sure why men are more likely to suffer multiple blood clots.  They speculated that hormonal or genetic factors may be involved.  This research was published in The Lancet.

 

Research published in the July 26th issue of the Journal of the American Medical Association (JAMA) could help explain. They say a test that measures the generation of a certain protein involved with blood clotting can help determine whether patients who have experienced a venous blood clot are at low risk of developing another blood clot.

Gregor Hron, M.D., of the Medical University of Vienna, Austria and colleagues conducted a study to determine whether by measuring thrombin generation (a protein in blood that causes clotting), patients with venous thromboembolism (VTE) could be stratified into high and low risk categories for recurrence of VTE. 

 

Their research concluded that patients without recurrent VTE had lower thrombin generation than patients with recurrence.  The authors wrote “In this large prospective cohort study, we found that patients with a first spontaneous VTE and peak thrombin generation of less than 400 nM [the measurement nanomolar] after discontinuation of vitamin K antagonists have a low risk of recurrence. According to Kaplan-Meier analysis, the likelihood of recurrent VTE in these patients was as low as 7 percent after 4 years … Compared with patients who had higher levels, those with peak thrombin generation less than 400 nM had an almost 60 percent lower risk of recurrence. Most importantly, the group of patients with low peak thrombin generation represented two-thirds of the total patient population.”

“ … we believe that our findings are of major clinical relevance. Using a simple commercially available laboratory method developed to measure thrombin generation, we were able to identify patients in whom the long-term risk of recurrent VTE is almost negligible. Considering the incidence rates of severe or fatal hemorrhage related to anticoagulant therapy and the case-fatality rate of recurrent VTE, patients with low peak thrombin generation (less than 400 nM) would almost certainly not benefit from indefinite anticoagulant therapy. Consequently, extensive thrombophilia screening appears to be unnecessary in this large, low-risk patient group,” the researchers conclude.

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