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3554 Increased D-Dimer Levels and Residual Venous Thrombosis Are Associated with Late Recurrence of Deep Venous Thrombosis

Pathophysiology of Thrombosis
Program: Oral and Poster Abstracts
Session: 331. Pathophysiology of Thrombosis: Poster III
Monday, December 7, 2015, 6:00 PM-8:00 PM
Hall A, Level 2 (Orange County Convention Center)

Bruna Moraes Mazetto, MSc1*, Fernanda Andrade Orsi, MD PhD2, Mariane Flores-Nascimento3*, Sandra Silveira3*, Luis Fernando Bittar3*, Kiara Zapponi3*, Marina Pereira Colella, MD, PhD4*, Erich Vinicius De Paula, MD, PhD4 and Joyce Maria Annichino-Bizzacchi, MD, PhD4*

1Hematology and Hemoterapy Center, University of Campinas, Campinas, Brazil
2Faculty of Medical Sciences, Department of Clinical Pathology, University of Campinas, Campinas, SP, Brazil
3Hematology and Hemoteraopy Center, University of Campinas, Campinas, Brazil
4Hematology and Hemotherapy Center, University of Campinas, Campinas, SP, Brazil

Background: Many patients present new thrombotic events even long-time after the first thrombotic episode and risk factors for recurrence in these cases are not fully elucidated.

Aim: To evaluate the risk of late recurrence of thrombosis after a first DVT episode.

Methods: This is a prospective observational study. We evaluated the association of D-dimer (DD) levels and persistent residual venous thrombosis (RVT), by Doppler ultrasound, with the occurrence of new thrombotic events long-time after the acute DVT episode.

Results: Fifty-six patients were enrolled for the study. For all patients, DVT episode occurred more than 12 months apart from the enrollment day. Median follow-up was 28 months. During the follow-up time, 10 patients presented thrombosis recurrence. Patients who suffered DVT recurrence had higher DD levels than those who did not had recurrence (median= 0.99 vs 0.40, respectively). The best cut-off value to discriminate those at risk for recurrence was DD > 0.63mg/L (area= 0.7380 95%CI= 0.5800 to 0.8961, P=0.01). Recurrence occurred in 27.7% of patients with previous DD>0.63mg/L and in 5.9% of patients with previous DD< 0.63mg/L (relative risk = 6.46; 95%CI 1.36- 30.52, P=0.007).  New thrombosis events occurred only in patients with previously documented RVT, mainly in patients with hypoechoic RVT. During follow-up, new thrombotic events were diagnosed in 75% of patients with hypoechoic RVT. The relative risk for recurrence according to the presence of RVT was 9.129 (95% CI= 2.60-32.02, P<0.001). The presence of RVT also modified the effect of DD on the recurrence risk. Patients with DD > 0,63mg/L but without RVT had similar risk of recurrence than those with DD< 0.63mg/L, whereas the risk for recurrence increased in 14-15 times in patients with RVT.

Conclusion: These results suggests that the persistence of residual thrombosis combined with high levels of DD, long-time after the acute DVT, are risk factors associated with late thrombosis recurrence.

Disclosures: No relevant conflicts of interest to declare.

*signifies non-member of ASH