ArticleResearch and practice in thrombosis and haemostasis2026
Risks of anticoagulation discontinuation after first venous thromboembolism in inherited thrombophilia: a long-term cohort study.
Article in Research and practice in thrombosis and haemostasis, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Inherited thrombophilia confers high venous thromboembolism (VTE) recurrence risk, and guidelines generally recommend indefinite anticoagulation after first VTE. However, long-term data comparing outcomes between patients who continue versus discontinue therapy are scarce. Objectives: To compare recurrent VTE and major bleeding (MB) risks between patients who continued versus discontinued anticoagulation after first VTE in inherited thrombophilia. Methods: We conducted a retrospective cohort study of 103 patients with protein S, protein C, or antithrombin deficiency who experienced first VTE between 1987 and 2023. Patients were grouped by anticoagulation status: 49 continued, 54 discontinued. The primary endpoint was recurrent VTE or MB. Results: Median age was 39 years (range, 11-81); 68% were male. Over median 6.0-year follow-up (interquartile range, 4.9-17.9 years), the composite endpoint occurred far more often in the discontinued versus continued group (66.7% vs 4.1%; HR, 20.23; 95% CI, 4.86-84.27; Conclusions: In patients with inherited thrombophilia, discontinuing anticoagulation markedly increased VTE recurrence without reducing bleeding. Our data support indefinite anticoagulation after first VTE in this population.
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