October 5, 2014

Just a DASH of VTE

DASH prediction model for reoccurrence risk in 1st time unprovoked VTE

Assessing the risk of recurrent VTE after a treatment period or determining when to stop therapy is a common concern amongst practitioners. 

The optimal goal of weighing ones bleeding risk versus their risk of VTE recurrence was the objective of a meta-analysis published by Tosetto et al in the Journal of Thrombosis and Haemostatis.

Data was collected from seven large prospective clinical trials involving 1,818 patients with first time unprovoked VTE treated with a vitamin K antagonist for a minimum of 3 months.

Four risk factors were isolated; Abnormal D-dimer after treatment, Age <50, Male Sex, Hormone use at the time of diagnosis

Cessation of anticoagulation is reasonable with a score of 1 or less as the risk of bleeding is equal to or surpasses the annual risk of reoccurrence.

Tosetto A, Iorio A, Marcucci M, et al. Predicting disease recurrence in patients with previous unprovoked venous thromboembolism: A proposed prediction score (DASH ). J Thromb Haemost. 2012;366:1019-1025.