Oral anticoagulation to prevent thrombosis recurrence in polycythemia vera and essential thrombocythemia

[EN] 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 vitami...

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Detalles Bibliográficos
Autores: Hernández-Boluda, J. C., Arellano-Rodrigo, E., Cervantes, F., Alvarez-Larrán, A., Gómez, M., Barba, P., Mata, M. I., González-Porras, J. R., Ferrer-Marín, F., García-Gutiérrez, V., Magro, E., Moreno, M., Kerguelen, A., Pérez Encinas, Manuel Mateo, Estrada, N., Ayala, R., Besses, C., Pereira, A.
Tipo de recurso: artículo
Fecha de publicación:2015
País:España
Institución:Servizo Galego de Saúde (SERGAS)
Repositorio:RUNA. Repositorio da Consellería de Sanidade e Sergas
OAI Identifier:oai:runa.sergas.gal:20.500.11940/8239
Acceso en línea:http://hdl.handle.net/20.500.11940/8239
Access Level:acceso abierto
Palabra clave:Anticoagulants
Polycythemia Vera
Thrombocythemia, Essential
Thrombosis
Trombosis
Trombocitemia Esencial
Policitemia Vera
Anticoagulantes
Descripción
Sumario:[EN] 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.

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