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Cohort studyResearch and practice in thrombosis and haemostasis · 2026

Risks of anticoagulation discontinuation after first venous thromboembolism in inherited thrombophilia: a long-term cohort study.

Sang-A Kim, Sin Young Park, Ji Yun Lee … Soo-Mee Bang

Internal MedicineCohort study

Stopping anticoagulation after first venous thromboembolism in thrombophilia linked to markedly higher recurrence risk

Risks of anticoagulation discontinuation after first venous thromboembolism in inherited thrombophilia: a long-term cohort study.

Sang-A Kim … Soo-Mee Bang

Research and practice in thrombosis and haemostasis · 2026

Background

Inherited thrombophilia confers high venous thromboembolism (venous thromboembolism) recurrence risk, and guidelines generally recommend indefinite anticoagulation after first venous thromboembolism.

Purpose

To compare recurrent venous thromboembolism and major bleeding (major bleeding) risks between patients who continued versus discontinued anticoagulation after first venous thromboembolism in inherited thrombophilia.

Methods

We conducted a retrospective cohort study of 103 patients with protein S, protein C, or antithrombin deficiency who experienced first venous thromboembolism between 1987 and 2023.

n = 103 patients

Results

stopping anticoagulation raised recurrence or bleeding risk 20-fold

HR 20.23 (95% CI 4.86 to 84.27)

null 1

4.86

84.27

CI excludes the null - significant

More results

Median age was 39 years (range, 11-81); 68% were male.

Ten-year event-free survival was 95.1% versus 42.1% ( P < .001), yielding a number needed to treat of 2.

This difference was driven by venous thromboembolism recurrence (63.0% vs 4.1%; adjusted HR, 19.85; P < .001).

Major bleeding occurred only in the discontinued group (5.6% vs 0%).

“

Conclusion · 1 of 2

In patients with inherited thrombophilia, discontinuing anticoagulation markedly increased venous thromboembolism recurrence without reducing bleeding.

Conclusion · 2 of 2

Our data support indefinite anticoagulation after first venous thromboembolism in this population.

Post

Risks of anticoagulation discontinuation after first venous thromboembolism in inherited thrombophilia: a long-term cohort study.

Stopping anticoagulation after first venous thromboembolism in thrombophilia linked to markedly higher recurrence risk

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