A recent study from China looked at the risk of recurrent pulmonary embolism using a meta analysis of a database of 42 trials involving nearly 37,000 cases.

The following factors were relative to recurrence of pulmonary embolism or deep vein thrombosis:

1. elevated D-dimer (1.77 (1.34 - 2.36), P = 0.000)

2. idiopathic pulmonary thromboemboolism (1.82 (1.61 - 2.05), P = 0.000)

3. right ventricular dysfunction (RVD)  (8.71 (2.38 - 31.91), P = 0.001)

4. persistent RVD vs non-RVD (2.45 (1.26 - 4.76)

5. short anticoagulation duration (1.73 (1.32 - 2.28)

6. increased endogenous thrombin generation capacity (1.89 (1.39 - 2.56)

7. elevated factor VIII (1.96(1.40 - 2.74)

8. positive antiphospholipid antibodies (5.64 (4.09 - 7.77)

9. anti-thrombin defect (2.45 (1.26 - 4.76)

10. male sex  (1.47 (1.06 - 2.03), P = 0.020)

When multiple factors co-existed, the risk of recurrence became more obvious.

The authors of the study (Yuan and colleagues) from the Department of Respiratory Disease & Critical Care Medicine, Second Hospital, Hebei Medical University, Shijiazhuang, China concluded that "elevated D-dimer, idiopathic PTE and many other factors may influence the recurrence of pulmonary embolism. And most recurrent patients have two or more factors".

Editor's note from www.VeinGuide.com - this is a very nice study from a well respected research group.