| Predictors of post-thrombotic syndrome in a population with a first deep vein thrombosis and no primary venous insufficiency. | |
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MedLine Citation:
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PMID: 23279046 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Post-thrombotic syndrome (PTS) is the most frequent complication of deep-vein thrombosis (DVT). Its diagnosis is based on clinical characteristics. However, symptoms and signs of PTS are non-specific and could be the consequence of concomitant primary venous insufficiency (PVI) rather than DVT. This could bias evaluation of PTS. METHODS: Using data from the REVERSE multicentre study, we assessed risk factors for PTS in patients with a first unprovoked unilateral proximal DVT 5-7 months earlier who were free of clinically significant PVI (defined as absence of moderate or severe venous ectasia in the contralateral leg). RESULTS: Among the 328 patients considered the prevalence of PTS was 27.1%. Obesity (OR=2.6[1.5-4.7]), mild contralateral venous ectasia (OR=2.2[1.1-4.3]), poor INR control (OR per additional 1% of time with INR<2 during anticoagulant treatment=1.018[1.003-1.034]) and presence of residual venous obstruction on ultrasound (OR=2.1[1.1-3.7]) significantly increased the risk for PTS in multivariable analyses. When restricting our analysis to patients without any signs, even mild, of contralateral venous insufficiency (n=244), prevalence of PTS decreased slightly to 24.6%. Only obesity remained an independent predictor of PTS (OR=2.6[1.3-5.0]). Poor INR control and residual venous obstruction also increased the risk, but results were no longer statistically significant (OR=1.017[0.999-1.035] and OR=1.7[0.9-3.3], respectively). CONCLUSIONS: After a first unprovoked proximal DVT, obese patients and patients with even mild PVI constitute a group at increased risk of developing PTS for whom particular attention should be paid with respect to PTS prevention. Careful monitoring of anticoagulant treatment may prevent PTS. © 2012 International Society on Thrombosis and Haemostasis. |
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Authors:
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J-P Galanaud; C A Holcroft; M A Rodger; M J Kovacs; M T Betancourt; P S Wells; D R Anderson; I Chagnon; G L Gal; S Solymoss; M A Crowther; A Perrier; R H White; L M Vickars; T Ramsay; S R Kahn |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-12-19 |
Journal Detail:
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Title: Journal of thrombosis and haemostasis : JTH Volume: - ISSN: 1538-7836 ISO Abbreviation: J. Thromb. Haemost. Publication Date: 2012 Dec |
Date Detail:
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Created Date: 2013-1-2 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101170508 Medline TA: J Thromb Haemost Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© 2012 International Society on Thrombosis and Haemostasis. |
Affiliation:
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Centre for Clinical Epidemiology, Jewish General Hospital, Montreal, Quebec, Canada. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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