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SHR Neuro Cancer Cardio Lipid Metab Microb

Kyrle, PA; Eischer, L; Šinkovec, H; Gressenberger, P; Gary, T; Brodmann, M; Heinze, G; Eichinger, S.
The Vienna Prediction Model for identifying patients at low risk of recurrent venous thromboembolism: a prospective cohort study.
Eur Heart J. 2024; 45(1):45-53 Doi: 10.1093/eurheartj/ehad618 [OPEN ACCESS]
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Co-authors Med Uni Graz

Brodmann Marianne

Gary Thomas

Gressenberger Paul Georg

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Abstract:

BACKGROUND AND AIMS: Patients with unprovoked venous thromboembolism (VTE) have a high recurrence risk, and guidelines suggest extended-phase anticoagulation. Many patients never experience recurrence but are exposed to bleeding. The aim of this study was to assess the performance of the Vienna Prediction Model (VPM) and to evaluate if the VPM accurately identifies these patients. METHODS: In patients with unprovoked VTE, the VPM was performed 3 weeks after anticoagulation withdrawal. Those with a predicted 1-year recurrence risk of ≤5.5% were prospectively followed. Study endpoint was recurrent VTE over 2 years. RESULTS: A total of 818 patients received anticoagulation for a median of 3.9 months. 520 patients (65%) had a predicted annual recurrence risk of ≤5.5%. During a median time of 23.9 months, 52 patients had non-fatal recurrence. The recurrence risk was 5.2% [95% confidence interval (CI) 3.2-7.2] at 1 year and 11.2% (95% CI 8.3-14) at 2 years. Model calibration was adequate after 1 year. The VPM underestimated the recurrence risk of patients with a 2-year recurrence rate of >5%. In a post-hoc analysis, the VPM's baseline hazard was recalibrated. Bootstrap validation confirmed an ideal ratio of observed and expected recurrence events. The recurrence risk was highest in men with proximal deep-vein thrombosis or pulmonary embolism and lower in women regardless of the site of incident VTE. CONCLUSIONS: In this prospective evaluation of the performance of the VPM, the 1-year rate of recurrence in patients with unprovoked VTE was 5.2%. Recalibration improved identification of patients at low recurrence risk and stratification into distinct low-risk categories.

Find related publications in this database (using NLM MeSH Indexing)

Male - administration & dosage

Humans - administration & dosage

Female - administration & dosage

Venous Thromboembolism - epidemiology

Prospective Studies - administration & dosage

Anticoagulants - therapeutic use

Pulmonary Embolism - administration & dosage

Recurrence - administration & dosage

Risk Factors - administration & dosage

Find related publications in this database (Keywords)

Venous thromboembolism

Recurrence

Vienna Prediction Model

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