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Guidelines for Anticoagulation Therapy for Secondary Prevention After Deep Vein Thrombosis



D-Dimer Levels and Risk of Recurrent Venous Thromboembolism4

Slide 10

June 2011

For these patients, we have taken to use the fibrin D-Dimer to help further risk stratify their risk of recurrence. And the way you do this study is that you have the patient take their prescribed duration of anticoagulants for treatment purposes, and then you stop the warfarin therapy for between 3 and 4 weeks and then you obtain a fibrin D-Dimer measure. If the fibrin D-Dimer is positive, they will have an associated risk of recurrent thrombosis of approximately10 percent per year. If, on the other hand, it is negative, then they will have between 2 and 3 percent risk of thrombosis per year if they remain off of Coumadin. This is essentially the same risk as major hemorrhage on Coumadin therapy which is perhaps between 2 and 3 percent. So if the risk of the disease is no better than the risk of treatment, then of course you would stop warfarin therapy.

Risk of Recurrent Venous Thromboembolism4

 


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