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La maladie veineuse thromboembolique : étude des facteurs de risque de récidive

Abstract : Based on data from two French hospital cohort studies, we investigated the riskfactors for recurrent venous thromboembolism (VTE).We confirmed the higher risk of recurrent VTE among men compared with womenand we suggested that this relation depended on age, Factor V Leiden mutation andhormone-related first event. A sex-specific analysis showed that advancing age, obesity andelevated D-dimer significantly increased the risk of recurrent VTE in women. Moreover, oralbut not transdermal estrogens, were associated with a higher risk of recurrent VTE amongpostmenopausal women. In men, factor V Leiden mutation, family history of arterial diseaseand an idiopathic first event were independent risk factors for VTE recurrence.The identification of sex-specific risk factors provides a new insight to riskstratification for VTE recurrence. These results could improve the prevention of this diseaseby an individual assessment of the optimal duration of anticoagulation therapy. In addition,our results provide first evidence supporting the safety of transdermal estrogens alone orcombined with micronized progesterone with respect to VTE recurrence risk. These datacould have important clinical implications for women with personal history of VTE whorequire hormone therapy for severe postmenopausal symptoms.
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Valérie Olié. La maladie veineuse thromboembolique : étude des facteurs de risque de récidive. Médecine humaine et pathologie. Université Paris Sud - Paris XI, 2011. Français. ⟨NNT : 2011PA11T016⟩. ⟨tel-00719318⟩

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