Risk factors associated with recurrent venous thromboembolism after a first cerebral venous thrombosis event: A cohort study

• Published in: Thrombosis research Vol. 178; pp. 85 - 90
• Main Authors: Pires, Giselli S., Ribeiro, Daniel D., Oliveira, João A.Q., Freitas, Luís C., Vaez, Rodrigo, Annichino-Bizzacchi, Joyce M., Morelli, Vânia M., Rezende, Suely M.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Ltd 01-06-2019
• Subjects: Adult; Cerebral venous thrombosis; Cohort Studies; Epidemiology; Female; Humans; Intracranial Thrombosis - complications; Intracranial Thrombosis - pathology; Male; Recurrence; Risk factor; Risk Factors; Venous thromboembolism; Venous Thromboembolism - etiology; Venous Thromboembolism - pathology; Young Adult; Recurrence; Epidemiology; Cerebral venous thrombosis; Venous thromboembolism; Risk factor
• ISSN: 0049-3848; 1879-2472
• DOI: 10.1016/j.thromres.2019.04.008

Cerebral venous thrombosis (CVT), although rare, is potentially fatal. Few studies have investigated risk factors associated with recurrent venous thromboembolism (VTE) after a first CVT event of which most are from Caucasian populations. The aim of this study was to evaluate risk factors associated with recurrent VTE after a first CVT event in a South American-population.
In this cohort, multicenter study, patients aged >18 years and objectively-diagnosed with CVT were included, with follow-up starting after discontinuing anticoagulant therapy. The primary outcome was symptomatic VTE recurrence at any venous site.
We included 203 patients with a median age of 30.8 (interquartile range [IQR], 24.7–40.9) years and a follow-up of 3.0 (IQR, 1.2–5.6) years. Most patients (86.2%) were women, and among those of reproductive age (n = 162), 65.4% developed CVT during oral contraceptive use, and 9.2% during pregnancy/puerperium. Thirteen patients (6.9%) developed VTE recurrence after a first CVT, yielding an overall rate of 1.6/100 patient-years (95% confidence interval [CI], 0.8–2.8). Recurrence rate was higher in males (4.6/100 patient-years; 95% CI, 1.2–11.7) than in females (1.2/100 patient-years; 95% CI, 0.6–2.4), and in patients with factor V Leiden mutation (9.2/100 patient-years; 95% CI, 1.1–33.1) than in those without it (1.2/100 patient-years; 95% CI, 0.5–2.4).
VTE recurrence after a first CVT was low. In spite of the limitation of small sample size, male sex and factor V Leiden mutation were the only factors associated with a significant higher risk of recurrent VTE after a first CVT in a multivariate analysis.
•Cerebral venous thrombosis (CVT) is a rare presentation of venous thromboembolism (VTE).•VTE recurrence after CVT has rarely been studied in admixed populations.•A total of 13/189 (6.9%) patients developed VTE recurrence after a first CVT.•Recurrence rate was higher in males and in patients with factor V Leiden mutation.