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    Poster Networking

    Venous Thromboembolism

    Poster Networking Session

    PB0486 - Effect of Age on Risk for Recurrent Venous Thromboembolism: A Systematic Review and Meta-Analysis

    Sunday, June 25, 2023
    18:30 – 19:30 ET
    Room: Exhibition
    Background: While there is compelling evidence that the risk of a first venous thromboembolism (VTE) increases exponentially with age, data on the association between age and the risk for recurrent VTE are limited and conflicting.

    Aims: To determine the effect of age at first unprovoked VTE on the risk for recurrent VTE up to 10 years after discontinuing anticoagulation, both overall and according to patient’s sex and site of initial VTE.

    Methods: Electronic databases were search for randomized trials and prospective cohort studies reporting recurrent VTE during follow-up after discontinuing anticoagulation across age categories ( < 50, 50–64, 65–75, and >75 years) of patients with a first unprovoked VTE who had completed ≥3 months of initial anticoagulant treatment. Number of recurrent VTE and person-years of follow-up were used to calculate incidence. Unpublished data required for analyses were obtained from authors of included studies.

    Results: A total of 10 studies with 4,605 patients were included in the analysis. The cumulative incidences of recurrent VTE among patients aged < 50 years and >75 years, respectively were 13.0% (95% CI, 8.9–17.7) and 18.9% (95% CI, 13.5–24.1) after 1 year and 32.4% (95% CI, 22.5–42.8) and 48.5% (95% CI, 34.0–62.1) at 10 years [Table]. The effect of advanced age (as compared with < 50 years age category) on the increased incidence of recurrent VTE varied according to patients’ sex and site of initial VTE [Figure].

    Conclusion(s): Advanced age at first unprovoked VTE is significantly associated with an increased long-term risk for recurrent VTE particularly among women and patients with an initial pulmonary embolism (with or without deep vein thrombosis). In addition to patient’s sex and site of initial VTE, age should also be considered when balancing the benefits and harms of long-term anticoagulation in individual patients with a first unprovoked VTE.