The cumulative incidence of VTE recurrence after 3 years differed significantly between different CTOI strata (P = 0.046) (Fig 2). Further, there was a significant association between continuous CTOI and VTE recurrence during the whole follow-up (adjusted SHR per 10% CTOI increase 1.27; 95% CI 1.12–1.45; P < 0.001), as well as between the RV/LV diameter ratio and VTE recurrence (adjusted SHR per unit increase 2.74; 95% CI 1.26–5.95; P = 0.01) (Table 3). The discriminative power of the CTOI (C-statistics 0.63; 95%CI 0.55–0.72) and the RV/LV diameter ratio (C-statistics 0.59; 95% CI 0.49–0.68) for VTE recurrence was moderate.