Venous thromboembolism is a disorder in which blood clots form in the deep-veins of the leg (venous thrombosis) and may move to the lungs (pulmonary embolism) with potentially fatal consequences. There are more than 250,000 patients with venous thrombosis or pulmonary embolism each year in the United States. The overall objective of our research is to improve our ability to prevent this disorder, to enhance the currently available diagnostic approaches, and to develop new approaches for treatment which improve the patient's clinical outcome.
Prevention is the key to reducing death and morbidity from venous thromboembolism. Most patients who die from pulmonary embolism do so suddenly with little or no warning, before a diagnosis can be made and before treatment can be instituted and take effect. Effective preventive approaches are available for most high-risk patient groups, but these are not perfect, and we are actively involved in clinical trials testing new, potentially more effective preventive measures.
Patients who develop deep-vein thrombosis are usually treated with anticoagulant drugs given intravenously in hospital for several days followed by oral anticoagulant treatment for three months. Recent studies indicate the long-term prognosis of patients with deep vein thrombosis is poor, with a 30% to 40% mortality over three years and a 15% to 20% rate of recurrent deep-vein thrombosis or pulmonary embolism. We are performing a randomized clinical trial to determine if extending the course of oral anticoagulant treatment from three months to three years will improve survival and reduce morbidity from recurrent thromboembolic events in these patients. If our hypothesis is correct, this could have major public health implications, with the potential for more than 15,000 lives saved each year in the United States. This study is being performed with the cooperation of colleagues in ten hospitals throughout the state of Oklahoma. A major general objective of our program is to continue to build a strong collaboration among this consortium of hospitals who will continue to work together on applied clinical research projects originating in Oklahoma.