Some Women With VTE May Be Able to Stop Anticoagulants

Larry Hand

September 06, 2016

ROME, ITALY — Women who score low on a particular clinical decision rule can safely discontinue taking anticoagulants after unprovoked venous thromboembolism, despite guidelines recommending lifelong anticoagulants, according to research presented at the European Society of Cardiology (ESC) 2016 Congress[1].

"We did a gender-stratified analysis of a cohort study that we completed in 2008[2] and identified the decision rule entitled Men Continue and HERDOO2," Dr Mark A Rodger (Ottawa Hospital, ON) said during a presentation at the meeting.

The acronym stands for a 4-point scale of hyperpigmentation edema or redness in either leg (HER), d-dimer blood test (D), obesity (O), and older age at least 65 years (O); the study aimed to develop a scoring tool to identify low-risk patients with unprovoked venous thrombosis who don't need to continue on anticoagulants.

"Men and women with two or more HERDOO points had a 14% risk of recurrent blood clots in the year after stopping anticoagulants in the derivation study," Rodger said. "Whereas women with zero or 1 HERDOO points had a 1.6% risk of recurrent blood clots in the year after stopping the study and found that they could stop their blood thinners."

The general rule is it's safe to discontinue anticoagulants if the risk at 1 year after stopping is less than 5%.

"In this largest cohort study of unprovoked venous thrombosis ever conducted, we demonstrated that women with zero to 1 HERDOO points can safely stop blood thinners. This is an important finding because 50% of women with unprovoked blood clots can be spared the burden, the costs, and the risks of lifelong anticoagulants," Rodger said.

Biomerieux provided grant funding for this Ottawa Hospital Research Institute study. Rodger reported no relevant financial relationships.

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