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Three Genes for Blood Clots - 23andMe Blog

Fracturing your hip or leg, having hip or knee replacement surgery, being immobilized like on a long flight, being pregnant, smoking, and taking oral birth control pills all increase risk for VTE to varying degrees. Genetics also plays a role and a new study by lead author John Heit from the Mayo Clinic suggests that variants of just three genes – F5, F2, and ABO – account for nearly all the possible genetic risk in people with European ancestry. These results imply that researchers are unlikely to discover new genetic factors that significantly impact VTE risk in the general population. Two of the three major genes have especially large impacts on risk for VTE. The F5 gene encodes the factor V clotting factor, a protein that causes blood cells to stick together.

Treatment Duration for Pulmonary Embolism | Pulmonary Medicine | JAMA | JAMA Network

The study compared the effects of giving blood-thinning medication for 6 months compared with 2 years. The study looked at how often people in each group had (1) another blood clot and (2) major bleeding as a side effect. The results showed a significantly lower risk of having another blood clot in the group that received the treatment for longer (2 years), without a major increase in bleeding risk.

Stopping anticoagulant therapy after an unprovoked venous thromboembolism

Importantly, the study by Rodger and colleagues confirms that patients who had a first unprovoked venous thromboembolism have a high overall risk of recurrence after stopping anticoagulant (about 11% at 1 year and about 17% at 2 years). In addition, they found no association between the presence of residual thrombosis of the deep veins on ultrasound and risk of recurrence, which argues against using this finding to determine the duration of treatment.

Stopping anticoagulant therapy after an unprovoked venous thromboembolism

Between these 2 extremes lie patients who have had a venous thromboembolism associated with a minor reversible risk factor (e.g., estrogen therapy or soft-tissue leg injury) and those who have had an “unprovoked” venous thromboembolism (also referred to as “idiopathic” or “spontaneous”).3 For patients with a minor reversible risk factor, the risk of recurrence is about 5% in the first year after stopping anticoagulant therapy.3 This is considered low enough to justify stopping anticoagulant therapy at the end of 3 months.1 However, an unprovoked proximal deep venous thrombosis or pulmonary embolism has a higher risk of recurrence (about 10% in the first year after stopping therapy). Continuing anticoagulant therapy beyond 3 months confers a greater than 90% risk reduction for preventing recurrence among these patients; however, if anticoagulants are subsequently stopped after 6 or 12 months of treatment, the risk of recurrence appears to be the same as if anticoagulants had been stopped after 3 months.1

Aspirin alone a good clot buster after knee surgery -- ScienceDaily

Over three months, just 1.16 percent of aspirin patients developed a serious blood clot. That was true for 1.42 percent of anticoagulant patients, according to the Michigan study. This was not statistically different. So, neither drug appeared better than the other -- but aspirin has some obvious advantages. "Aspirin is easy to take and much less expensive," Hallstrom says. "Patients can get it over the counter for pennies, while the other anticoagulants require monitoring, injections, frequent dose adjustments and are extremely expensive." The reported cost for a 30-day supply of rivaroxaban is approximately $379 to $450; heparin is estimated at $450 to $890. Although warfarin costs a few dollars for a 30-day supply, its cost approaches that of the other anticoagulants when doctor visits for monitoring are factored in, Hallstrom says.