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Can We Better Predict Who Is Most Likely to Have Another VTE After a First Event? – RPTH Journal
RPTH Journal/LinkedIn
Apr 12, 2026, 13:21

Can We Better Predict Who Is Most Likely to Have Another VTE After a First Event? – RPTH Journal

RPTH Journal shared a post on LinkedIn about a recent article by Eugenia Biguzzi, adding:

”Can we better predict who is most likely to have another VTE after a first event?

A new RPTH study suggests that combining d-dimer with thrombin generation may improve risk stratification for recurrent venous thromboembolism. In this cohort of 1,895 patients, recurrence risk was lowest in those with low d-dimer + low thrombin generation, intermediate when only 1 marker was elevated, and highest when both were elevated.

The signal was especially striking in unprovoked VTE. Patients with high d-dimer and high thrombin generation had an incidence rate of 9.80 per 100 patient-years, compared with 1.36 per 100 patient-years in those with low levels of both markers, with an adjusted hazard ratio of 8.59.

Why this matters:

Extending anticoagulation lowers recurrence risk, but bleeding risk remains the tradeoff. Tools that better separate low-, intermediate-, and high-risk patients could help guide more personalized decisions after a first VTE.

A key caveat: thrombin generation was measured with a specialized assay, which may limit immediate routine clinical use. Still, this study adds to the push toward biomarker-guided anticoagulation decisions rather than relying on broad clinical categories alone.”

Title: Recurrent venous thromboembolism: association with thrombin generation and d-dimer

Authors: Eugenia Biguzzi, Kristien Winckers, Tilman M. Hackeng, Frits R. Rosendaal, Astrid van Hylckama Vlieg

Read the Full Article on RPTH

Can We Better Predict Who Is Most Likely to Have Another VTE After a First Event? - RPTH Journal

 

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Astrid van Hylckama Vlieg D dimer Eugenia Biguzzi Frits R Rosendaal Health Hematology Hemostasis Hemostasis News Hemostasis Today Kristien Winckers Medicine RPTH Journal thrombosis Tilman M. Hackeng VTE
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