Riesgo de recurrencia en el tromboembolismo venoso idiopático

espanolEn pacientes con enfermedad tromboembolica venosa idiopatica (no provocada) el riesgo de recurrencia es elevado. La profilaxis secundaria con terapia anticoagulante reduce el riesgo trombotico, pero a expensas de un incremento del riesgo de hemorragias. Algunos factores, como el sexo masculino o una elevacion de la concentracion de dimero-D tras finalizar la anticoagulacion, se asocian a un mayor riesgo de recidiva; otros, como la trombosis venosa residual, tienen una relacion mas controvertida, incluso contradictoria. Se han propuesto algunos modelos de prediccion del riesgo de recurrencia trombotica tras la anticoagulacion en la ETEV no provocado, pero necesitan una validacion externa para conocer su utilidad real en la practica clinica. En este articulo se analizan los factores de riesgo de recidiva trombotica y los modelos de prediccion existentes. EnglishFor patients with idiopathic venous thromboembolism (unprovoked), the risk of recurrence is high. Secondary prophylaxis with anticoagulant therapy reduces the thrombotic risk but at the expense of an increased risk of haemorrhage. A number of factors, such as the male sex and an increase in dimer-D concentrations after completing the anticoagulation therapy, are associated with an increased risk of recurrence. Other factors such as residual venous thrombosis have a more controversial and sometimes contradictory relationship. A number of models have been proposed for predicting thrombotic recurrence risk after anticoagulation therapy in unprovoked TVD. However, these models need external validation to determine their current usefulness in clinical practice. In this article, we analyse the risk factors for thrombotic recurrence and the existing prediction models.