Evaluation of the PADIS score stratifying risk for venous thromboembolism recurrence after a first unprovoked pulmonary embolism. Results from the REVERSE study.

Current guidelines suggest that most patients presenting with a first episode of an unprovoked venous thromboembolism (VTE) event be considered for indefinite anticoagulation, as long as their bleeding risk remains acceptably low [1, 2]. However, this exposes a considerable number of patients to long term anticoagulation as 70% of patients with a first unprovoked VTE will have no recurrence [3]. In 2010, a guidance from the International Society on Thrombosis and Haemostasis (ISTH) suggested that a 1-year cumulative rate of recurrent VTE after stopping anticoagulation of less than 5%, with a 95% confidence interval (CI) upper limit lower than 8%, is low enough to consider that long-term anticoagulant therapy would not be beneficial [4]. As such, efforts are ongoing to identify risk factors and scoring tools to help discriminate between subsets of patients whose risk/benefit ratio most- or least- strongly favours continued therapy. Footnotes This manuscript has recently been accepted for publication in the European Respiratory Journal . It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.