Division of Cardiology, Department of Medicine, Heart and Vascular Institute, Vanderbilt University Medical Center, 1215 Ave South Medical Center East, 5th Floor, South Tower, Nashville, TN, 37232-8802, USA.
Curr Cardiol Rep. 2019 Mar 4;21(4):24. doi: 10.1007/s11886-019-1111-2.
Venous thromboembolism (VTE) is a common condition with significant associated morbidity and mortality. Recurrent VTE after an initial episode is a preventable medical condition. The following review discusses data supporting recurrence risk estimates after an initial VTE episode as well as treatment strategies to mitigate risk of recurrent VTE.
This review particularly highlights methods for stratifying the risk of recurrent VTE and recent studies that have evaluated direct oral anticoagulants for the prevention of recurrent VTE. Risk assessment for VTE recurrence should guide anticoagulation duration. In patients who present with unprovoked VTE events, there remains a high risk of recurrence that is significantly mitigated with extended duration anticoagulation with either a vitamin K antagonist or direct oral anticoagulant.
静脉血栓栓塞症（VTE）是一种常见病症，具有显著的相关发病率和死亡率。初始发作后 VTE 的复发是一种可预防的医疗状况。以下综述讨论了支持初始 VTE 发作后复发风险估计的数据，以及减轻 VTE 复发风险的治疗策略。
本综述特别强调了分层 VTE 复发风险的方法，以及最近评估直接口服抗凝剂预防 VTE 复发的研究。VTE 复发的风险评估应指导抗凝持续时间。在无诱因 VTE 事件的患者中，复发风险仍然很高，用维生素 K 拮抗剂或直接口服抗凝剂延长抗凝时间可显著降低复发风险。
