Negative d‐dimers justify stopping anticoagulants in women but not in men after a first unprovoked venous thromboembolism, a Canadian study shows.
Long‐term VTE recurrence risk was high for men with negative d‐dimer levels in the five years after a first unprovoked proximal DVT or pulmonary embolism (PE), but not for women, according to results published in the Journal of Thrombosis and Haemostasis.
In the study, 410 patients with a first unprovoked VTE had anticoagulants stopped if d‐dimer was negative on therapy and one month after stopping therapy.
The subsequent rate of recurrent VTE was 5.1% per patient‐year overall, 7.5% in men, 3.8% in women (with VTE not associated with oral contraception or hormone replacement therapy) and 0.4% in women with VTE associated with oestrogens.
Cumulative risk of recurrence at five years was 21.5% overall, 29.7% in men, 17.0% in women not taking oestrogen and 2.3% in oestrogen-using women.
The study investigators said their findings should help inform decisions about whether a patient with unprovoked VTE should receive indefinite anticoagulation or not.