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dc.contributor.authorDe Winter, Maria A.
dc.contributor.authorBüller, Harry R.
dc.contributor.authorCarrier, Marc
dc.contributor.authorCohen, Alexander T.
dc.contributor.authorHansen, John Bjarne
dc.contributor.authorKaasjager, Karin A. H.
dc.contributor.authorKakkar, Ajay K.
dc.contributor.authorMiddeldorp, Saskia
dc.contributor.authorRaskob, Gary E.
dc.contributor.authorSørensen, Henrik T.
dc.contributor.authorVisseren, Frank L. J.
dc.contributor.authorWells, Philip S.
dc.contributor.authorDorresteijn, Jannick A. N.
dc.contributor.authorNijkeuter, Mathilde
dc.contributor.authorBrækkan, Sigrid Kufaas
dc.description.abstractAims Deciding to stop or continue anticoagulation for venous thromboembolism (VTE) after initial treatment is challenging, as individual risks of recurrence and bleeding are heterogeneous. The present study aimed to develop and externally validate models for predicting 5-year risks of recurrence and bleeding in patients with VTE without cancer who completed at least 3 months of initial treatment, which can be used to estimate individual absolute benefits and harms of extended anticoagulation.<p> <p>Methods and results Competing risk-adjusted models were derived to predict recurrent VTE and clinically relevant bleeding (non-major and major) using 14 readily available patient characteristics. The models were derived from combined individual patient data from the Bleeding Risk Study, Hokusai-VTE, PREFER-VTE, RE-MEDY, and RE-SONATE (n = 15,141, 220 recurrences, 189 bleeding events). External validity was assessed in the Danish VTE cohort, EINSTEIN-CHOICE, GARFIELD-VTE, MEGA, and Tromsø studies (n = 59 257, 2283 recurrences, 3335 bleeding events). Absolute treatment effects were estimated by combining the models with hazard ratios from trials and meta-analyses. External validation in different settings showed agreement between predicted and observed risks up to 5 years, with C-statistics ranging from 0.48–0.71 (recurrence) and 0.61–0.68 (bleeding). In the Danish VTE cohort, 5-year risks ranged from 4% to 19% for recurrent VTE and 1% –19% for bleeding. <p>Conclusion The VTE-PREDICT risk score can be applied to estimate the effect of extended anticoagulant treatment for individual patients with VTE and to support shared decision-making.en_US
dc.identifier.citationDe Winter, Büller, Carrier, Cohen, Hansen, Kaasjager, Kakkar, Middeldorp, Raskob, Sørensen, Visseren, Wells, Dorresteijn, Nijkeuter, Brækkan. Recurrent venous thromboembolism and bleeding with extended anticoagulation: the VTE-PREDICT risk score. European Heart Journal. 2023;44(14):1231-1244en_US
dc.identifier.cristinIDFRIDAID 2175909
dc.publisherOxford University Pressen_US
dc.relation.journalEuropean Heart Journal
dc.rights.holderCopyright 2023 The Author(s)en_US
dc.rightsAttribution-NonCommercial 4.0 International (CC BY-NC 4.0)en_US
dc.titleRecurrent venous thromboembolism and bleeding with extended anticoagulation: the VTE-PREDICT risk scoreen_US
dc.typeJournal articleen_US
dc.typePeer revieweden_US

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Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)
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