Unraveling the Genetic Basis of Recurrent Venous Thromboembolism
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See Article by de Haan et al
Venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, is a worldwide health problem affecting people of all ages, sexes, cultures, and races. Recent estimates suggest that upward of 10 million people had VTE at an annual cost from hospitalization, treatment, and days lost from work of at least $60 billion.1,2 It is prevalent in low-, middle-, and high-income countries with annual incidence rates ranging from 0.75 to 2.69 per 1000 individuals. In addition, VTE is among the leading causes of disability-adjusted life years lost.3 In the Global Burden of Disease Project,4 incidence rates for VTE were 115 and 269 per 100 000 people among men and women, respectively, and mortality rates ranged from 9.4 to 32.3. Despite the burden of VTE, global public awareness was ≈50% lower compared with myocardial infarction or stroke.
VTE is often associated with recurrence after convalescence from the initial event. An unprovoked initial VTE is a particularly strong risk factor for recurrence, suggesting that ≥1 underlying genetic factors may play an important role. One must consider the possibility that the genetics of recurrence may differ from that of an initial, unprovoked VTE. There is clinical uncertainty on the optimal duration of anticoagulation after treatment of initial VTE to prevent recurrence; therefore, deeper insight into the underlying mechanisms of recurrence may ultimately help tailor duration of anticoagulation to those at highest risk. Clinicians working closely with the scientific community on a foundation of precision medicine seek guidance for predicting recurrent VTE.
Prior investigation into the genetics …