Erschienen in:
01.06.2015 | Original Article
Oral anticoagulation to prevent thrombosis recurrence in polycythemia vera and essential thrombocythemia
verfasst von:
Juan-Carlos Hernández-Boluda, Eduardo Arellano-Rodrigo, Francisco Cervantes, Alberto Alvarez-Larrán, Montse Gómez, Pere Barba, María-Isabel Mata, José-Ramón González-Porras, Francisca Ferrer-Marín, Valentín García-Gutiérrez, Elena Magro, Melania Moreno, Ana Kerguelen, Manuel Pérez-Encinas, Natàlia Estrada, Rosa Ayala, Carles Besses, Arturo Pereira, on behalf of the Grupo Español de Enfermedades Mieloproliferativas Filadelfia Negativas (GEMFIN)
Erschienen in:
Annals of Hematology
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Ausgabe 6/2015
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Abstract
It is unclear whether anticoagulation guidelines intended for the general population are applicable to patients with polycythemia vera (PV) and essential thrombocythemia (ET). In the present study, the risk of thrombotic recurrence was analyzed in 150 patients with PV and ET treated with vitamin K antagonists (VKA) because of an arterial or venous thrombosis. After an observation period of 963 patient-years, the incidence of re-thrombosis was 4.5 and 12 per 100 patient-years under VKA therapy and after stopping it, respectively (P < 0.0005). After a multivariate adjustment for other prognostic factors, VKA treatment was associated with a 2.8-fold reduction in the risk of thrombotic recurrence. Notably, VKA therapy offset the increased risk of re-thrombosis associated with a prior history of remote thrombosis. Both the protective effect of VKA therapy and the predisposing factors for recurrence were independent of the anatomical site involved in the index thrombosis. Treatment periods with VKA did not result in a higher incidence of major bleeding as compared with those without VKA. These findings support the use of long-term anticoagulation for the secondary prevention of thrombosis in patients with PV and ET, particularly in those with history of remote thrombosis.