A retrospective study on oral anticoagulant prophylaxis in 103 Italian patients with hereditary thrombophilia and thrombosis |
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Authors: | Guido Finazzi Tiziano Barbui the ad hoc Study Group |
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Institution: | (1) Divisione di Ematologia, Ospedali Riuniti di Bergamo, Largo Barozzi 1, 24100 Bergamo, Italia |
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Abstract: | Summary The clinical records of 103 Italian patients with inherited thrombophilia and thrombosis were reviewed to estimate the incidence
of thrombotic recurrences and major bleeding complications according to the different duration of oral anticoagulant prophylaxis
(OAP). The incidence of the first thrombotic recurrence was 2.9, 7.4 and 10.8×100 patients/year, respectively, in subjects
receiving lifelong OAP, stopping OAP after a mean of 9 months (range 1–30 months) or not receiving OAP. The probability to
remain free from thrombotic recurrences in patients undergoing lifelong OAP, as estimated by the Kaplan-Meier method, was
significantly higher in comparison with untreated patients (p<0.001), but did not reach the statistical significance in comparison
with patients who stopped prophylaxis. The incidence of further thrombotic recurrences was 1.2, 21.1 and 22.3×100 patients/year,
respectively, in the three groups defined above. The difference between patients who prolonged indefinitely OAPvs those who stopped or did not receive OAP was statistically significant (p=0.003). Two intracranial bleedings, one of which
fatal, were observed in patients undergoing lifelong OAP, whereas no major bleeding complications occurred in the other two
groups. Our study supports the recommendations to continue indefinitely OAP in patients with inherited thrombophilia and recurrent
thrombosis, but suggests caution in starting lifelong prophylaxis soon after the first thrombotic event in all patients.
Members of the Study Group: F. Baudo (Milano); M. Berrettini (Perugia); G. Castaman (Vicenza); N. Ciavarella (Bari); S. Coccheri
(Bologna); V. De Stefano (Roma); A. G. Dettori (Parma); N. Erba (Merate); G. Leone (Roma); P. M. Mannucci (Milano); C. Manotti
(Parma); M. G. Mazzucconi (Roma); G. Palareti (Bologna); F. Panicucci (Pisa); E. Pogliani (Monza); F. Rodeghiero (Vicenza);
A. Tripodi (Milano). |
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Keywords: | Antithrombin III Genetic defects Hereditary thrombotic syndromes Oral anticoagulants Protein C Protein S Thrombosis |
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