Is there a gender difference in risk of recurrent thromboembolism?

January 01, 0001

Is there a gender difference in risk of recurrent thromboembolism?

Significant health care resources are spent in preventing recurrence of thromboembolism. This group of European and North American researchers examined the effect of gender on the risk of recurrent venous thromboembolism. They performed a search of Medline, Embase, CINAHL, ans Cochrane Central Register of Controlled Trials with additional searching of conference abstracts and suggestions from experts. Seven prospective studies yielded 2554 patients with a first venous thromboembolism had follow-up for a mean of 27.1 months.

The researchers found: "The one year incidence of recurrent venous thromboembolism was 5.3% in women and 9.5% in men, and the three year incidence of recurrence was 9.1% in women and 19.7% in men. Among patients with unprovoked venous thromboembolism, men had a higher risk of recurrence than did women (hazard ratio 2.2. After adjustment for women with hormone associated initial venous thromboembolism, the risk of recurrence remained higher in men (hazard ratio 1.8). In patients with provoked venous thromboembolism, occurring after exposure to a major risk factor, recurrence of disease did not differ between men and women (hazard ratio 1.2). In women with hormone associated venous thromboembolism and no other risk factors, recurrence was lower than that in women with unprovoked venous thromboembolism and no previous hormone use (hazard ratio 0.5)."

The researchers concluded: "In patients with a first unprovoked venous thromboembolism, men have a 2.2-fold higher risk of recurrent venous thromboembolism than do women, which remained 1.8-fold higher in men after adjustment for previous hormone associated venous thromboembolism in women. In patients with a first provoked venous thromboembolism, risk of recurrence does not differ between men and women with or without hormone associated venous thromboembolism. Indefinite anticoagulation may be given greater consideration in men than in women after a first venous thromboembolism."

Men have a higher rate of recurrence of thromboembolism than women

For the full abstract, click here.

BMJ 342:d813, 24 February 2011
© 2011 BMJ Publishing Group Ltd.
Risk of recurrence after venous thromboembolism in men and women: patient level meta-analysis. James Douketis, Alberto Tosetto, Maura Marcucci, et al.. Correspondence to J Douketis: [email protected]

Category: B. Blood/Immune Mechanisms. Keywords: thromboembolism, gender, provoked, unprovoked, anticoagulation, systematic review with meta-analysis, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 25 March 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.