SHM's Clinical Quick Talks-One-Minute Guide to Thrombophilia Testing

One-Minute Guide to Thrombophilia Testing

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Thrombophilia testing is a topic that has been studied extensively due to the high prevalence and severity of venous thromboembolism (VTE). Two separate studies were conducted, one in Britain and the other in Italy, to determine the rate of recurrence of VTE in patients with provoked and unprovoked thromboses. The British study followed a cohort of 570 patients for two years and found that none of the patients with a provoked initial VTE had a recurrence during the observation period. The Italian study followed 1,626 patients for a minimum of 10 years and reported a recurrence of VTE in 23% of patients. The study concluded that previous unprovoked VTE and thrombophilia were significantly associated with an increased risk of recurrence. However, the effect of an underlying thrombophilic condition varied between the two studies, potentially due to the inclusion or exclusion of antiphospholipid antibody syndrome (APS) in the analysis.<br /><br />Based on these findings, it is not recommended to routinely test patients with a first occurrence of provoked VTE for hereditary thrombophilia. Testing patients with unprovoked VTE for hereditary thrombophilia should only be done if it will alter management. This suggests that thrombophilia testing may not be of significant utility in determining the risk of recurrence and guiding treatment decisions for patients with VTE. <br /><br />Overall, the studies highlight the higher risk of recurrence in patients with unprovoked VTE and the need to consider the presence of an underlying thrombophilic condition in determining this risk. However, further research is needed to fully understand the impact of hereditary thrombophilia on VTE recurrence and its implications for patient management.

Keywords

Thrombophilia testing

venous thromboembolism

recurrence of VTE

provoked thromboses

unprovoked thromboses

British study

Italian study

risk of recurrence

thrombophilic condition

hereditary thrombophilia