Kyrle Paul Alexander, Eichinger Sabine
Division of Hematology and Hemostasis, Ludwig Boltzmann-Institute for Thrombosis Research, Department of Internal Medicine I, Vienna University Hospital, Vienna, Austria.
Wien Klin Wochenschr. 2003 Aug 14;115(13-14):471-4. doi: 10.1007/BF03041030.
Venous thromboembolism (VTE) is a chronic disease. After withdrawal of oral anticoagulation at least a third of patients will experience a subsequent episode of venous thrombosis. Of these patients, approximately 5% will die from pulmonary embolism. The Austrian Study on Recurrent Venous Thromboembolism (AUREC) is a prospective cohort study aiming to investigate the overall rate of recurrent VTE, the predictive value of laboratory assays, the importance of acquired or congenital risk factors for thrombosis and the impact of extended or modified secondary thromboprophylaxis on the risk of recurrence among high-risk patients. So far, the AUREC investigators have identified subgroups of patients with a particular high risk of recurrence: patients with a history of venous thrombosis, elevated levels of coagulation factors VIII, IX and XI, pulmonary embolism or superficial venous thrombosis and a history of venous thrombosis and hyperhomocysteinemia. Patients with a history of venous thrombosis and mutations in genes encoding for coagulation factors (factor V Leiden, factor II, G20210A) do not have an enhanced risk of recurrence and, thus, do not qualify for extended secondary thromboprophylaxis. At present, interventional trials are in progress in patients with high factor VIII or hyperhomocysteinemia in order to investigate if these patient groups might benefit from extended oral anticoagulation or vitamin supplementation, respectively.
静脉血栓栓塞症（VTE）是一种慢性疾病。在停用口服抗凝药后，至少三分之一的患者会再次发生静脉血栓形成。在这些患者中，约5%会死于肺栓塞。奥地利复发性静脉血栓栓塞症研究（AUREC）是一项前瞻性队列研究，旨在调查复发性VTE的总体发生率、实验室检测的预测价值、获得性或先天性血栓形成危险因素的重要性，以及延长或调整二级血栓预防对高危患者复发风险的影响。到目前为止，AUREC研究人员已经确定了复发风险特别高的患者亚组：有静脉血栓形成病史、凝血因子VIII、IX和XI水平升高、肺栓塞或浅静脉血栓形成病史以及有静脉血栓形成和高同型半胱氨酸血症病史的患者。有静脉血栓形成病史且凝血因子编码基因（因子V Leiden、因子II、G20210A）发生突变的患者复发风险并未增加，因此不符合延长二级血栓预防的条件。目前，针对凝血因子VIII水平高或同型半胱氨酸血症高的患者正在进行干预试验，以分别研究这些患者群体是否可能从延长口服抗凝或维生素补充中获益。
