Predictive Variables in Cardiovascular Disease
DRAFT Subcommittee Minutes
23 July 2011
09:00-13:00
Room D
Chairman: James Douketis (CA)
Co-chairmen: Gordon Lowe (UK), Karel Moons (NL), Frederick Spencer (CA), Alberto Tosetto (IT), Richard White (US)
Educational and SSC Activity Update Session
- This was a well-attended session, taking place on July 23rd from 9AM-1PM; it was co-chaired by Drs. James Douketis and Richard White
- The session began with the Educational Session, devoted to a comparison of the incidence, and determinants of VTE and cardiovascular disease in different racial groups (whites, blacks, Asians); the presenters were Drs. Rich White (USA), Shinya Goto (Jp) and Mary Cushman (USA).
- The second part addressed ongoing SSC collaborative activities relating to determinants of cardiovascular disease (Dr. Olivia Wu, UK), D-dimer to predict stroke risk (Dr. John Eikelboom, Can) and ongoing studies in this area (Drs. Marc Rodger, Can, Dr. Paolo Prandoni, It, and Dr. Geert-Jan Geersing, Neth).
- The session ended with a spirited debate by Drs. White and Cushman on the pros/cons of thrombophilia testing in patients with otherwise unprovoked VTE.
Subcommitte Activities
- The committee continues to promote a collaborative project assessing D-dimer and other determinants of recurrent VTE, with the aim of better distinguishing patients at low and high risk for disease recurrence. To date, three papers relating to this work have been published (J Thromb Haemost, Ann Intern Med, BMJ), and a fourth is submitted for publication (JAMA).
- Annual meetings of this project have been held since 2009, with a meeting in Kyoto held on July 23rd and attended by 9 collaborators. Ongoing studies assessing D-dimer and other predictors of recurrence, including DULCIS, REVERSE-2, MORGAGNI, and VISTA were discussed, with feedback provided to the lead investigators.
- The committee has promoted and contributed to the development of a new patient-level pooled data analysis of studies assessing the utility of residual vein occlusion (RVO) to determine recurrence risk after DVT; this work aims to clarify an area where there is considerable uncertainty.
- Additional studies by this collaborative project are in progress using pooled patient-level data relating to (a) development of a clinical prediction guide for recurrent VTE, (b) determinants of recurrence risk after provoked VTE, and (c) effects of thrombophilia markers (factor V Leiden) on recurrence risk.
