Background
Venous thrombo-embolic disease (VTE) is a common condition with an
estimated annual incidence of 1-2 / 1000 persons [1]. Its incidence
has remained stable during the last decade [1]. VTE is related to a
mortality rate estimated between 20 and 25% at 5 years and is
considered as a chronic multifactorial pathology [2]. Indeed, it
involves many risk factors which can be classified as constitutional or
acquired, transitory or persistent. Consensually, inherited
thrombophilia (IT) screening includes testing for both natural inhibitor
(antithrombin (AT), protein C (PC) and protein S (PS)) deficiencies and
polymorphisms of factor V Leiden and prothrombin G20210A mutation. It is
currently admitted that IT increases the risk of a first thrombotic
event. Indeed it is found in 50% of patients with VTE [3]. So far,
it has provided an explanation for VTE and justified indefinite
anticoagulation to prevent recurrences after treatment withdrawal
[4]. However, according to more recent data, impact of thrombophlia
on the risk of recurrence is unclear [5]. Recent guidelines did not
consider thrombophilia in therapeutic management of VTE. Consequently,
guidelines from the American college of chest physicians (ACCP) [6]
do not include thrombophilia in the treatment duration. For others such
as the European society of Cardiology (ESC) [7] and the national
Institute for Health and Care Excellence (NICE) [8], the assessment
of thrombophilia can modulate the treatment duration in selected
situations. In the absence of a clear consensus in clinical practice,
this study aimed to evaluate the impact of IT on therapeutic decisions
and on predicting the risk of VTE recurrence.