Impact of high risk thrombophilia status on recurrence among children and adults with VTE: An observational multicenter cohort study.

Abstract

BACKGROUND:

Antithrombin [AT]-, protein C [PC]- or protein S [PS]-deficiency [D] constitutes a major risk factor for venous thromboembolism [VTE]. Primary study objective was to evaluate if the clinical presentation at first VTE onset differs between children and adults and to compare the individual recurrence risk among patients with respect to age at onset and their thrombophilia status ATD, PCD or PSD.

METHODS/PATIENTS/RESULTS:

In 137 of 688 consecutively enrolled pediatric and adult VTE patients we calculated the absolute risk of VTE recurrence and event-free-survival adjusted for thrombophilia and positive family VTE history. At first VTE children manifested i) with a lower rate of pulmonary embolism, ii) a higher rate of cerebral vascular events or multiple VTEs, and iii) showed a higher proportion of unprovoked VTE compared to adolescents and adults. Adult patients reported more often a positive VTE history compared to younger study participants. The adjusted odds of recurrence in adults was 2.05 compared to children.

CONCLUSION:

At disease manifestation children and adults differ with respect to i) thrombotic locations, ii) percentage of unprovoked versus provoked VTE, and iii) different rates of positive VTE family histories. Furthermore, adults showed a two-fold increase risk of VTE recurrence compared to children.

• Authors: Gloria Brüwer, Verena Limperger, Gili Kenet, Ulrich C Klostermeier, Maria Shneyder, Frauke Degenhardt, Ulrich Finckh, Christine Heller, Susanne Holzhauer, Ralf Trappe, Karim Kentouche, Ralf Knoefler, Karin Kurnik, Anne Krümpel, Melchior Lauten, Daniela Manner, Rolf Mesters, Ralf Junker, Ulrike Nowak-Göttl
• Journal: Blood cells, molecules & diseases (Blood Cells Mol Dis) Vol. 62 Pg. 24-31 (11 2016) ISSN: 1096-0961 [Electronic] United States
• PMID: 27838551 (Publication Type: Journal Article, Multicenter Study, Observational Study, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2016 Elsevier Inc. All rights reserved.

Topics

• Adolescent
• Adult
• Age Factors
• Child
• Child, Preschool
• Cohort Studies
• Humans
• Medical History Taking
• Middle Aged
• Protein C Deficiency
• Protein S Deficiency
• Recurrence
• Risk Factors
• Thrombophilia (complications)
• Venous Thromboembolism (etiology, pathology)
• Young Adult