The Long-Term Clinical Course of Acute Deep Venous Thrombosis

Prandoni, Paolo; Lensing, Anthonie W. A.; Cogo, Alberto; Cuppini, Stefano; Villalta, Sabina; Carta, M.; Cattelan, Anna María; Polistena, P.; Bernardi, Enrico; Prins, Martin H.

doi:10.7326/0003-4819-125-1-199607010-00001

Cited by 1,952 publications

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“…21 It has been shown that recurrence of ipsilateral DVT is a strong predictor of PTS and that long periods of anticoagulation and wearing CS seems to prevent it. [40][41][42][43] In this study, there was a greater number of TG patients with ipsilateral rethrombosis among those who had CEAP≥3 than among thrombophilic patients with CEAP<3, but the difference did not attain statistical significance. We did not observe any difference between thrombophilic and control groups in terms of complaints or CEAP-based physical examination findings, in contrast with reports that have shown lower PTS incidence in patients with genetic thrombophilia.…”

Section: Discussioncontrasting

confidence: 58%

Long-term clinical and ultrasonographic evaluation of thrombophilic patients with deep venous thrombosis

et al. 2014

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Objective: The purpose of this study was to evaluate the long term clinical and ultrasonographic outcomes of thrombophilic patients with deep venous thrombosis (DVT). Method: Cohort study, retrospective case-control with cross-sectional analysis. Thirty-nine thrombophilic patients and 25 non-thrombophilic patients were assessed 76.3 ± 45.8 months after diagnosis. Demographic and family data were collected, as well as data from clinical and therapeutic progress, and physical and ultrasound examinations of the limbs were performed. Groups were matched for age and gender and the variables studied were compared across groups. Results: Deep venous thrombosis was more frequent in women. The most common thrombophilias were antiphospholipid syndrome and factor V Leiden mutation. There was no difference between groups in terms of the number of pregnancies or miscarriages and the majority of women did not become pregnant after DVT. Non-spontaneous DVT prevailed. Proximal DVT and DVT of the left lower limb were more frequent, and the main risk factor was use of oral contraceptives. All patients were treated with anticoagulation. There was a higher frequency of pulmonary embolism in non-thrombophilic patients. Most patients considered themselves to have a "normal life" after DVT and reported wearing elastic stockings over at least 2 years. Seventy-one percent of patients had CEAP ≥ 3, with no difference between groups. Deep venous reflux was more frequent in thrombophilic patients. Conclusion: There were no significant differences between groups with respect to most of the variables studied, except for a higher frequency of pulmonary embolism in non-thrombophilic patients and greater frequency of deep venous reflux in thrombophilic patients.Keywords: deep vein thrombosis; thrombophilia; postthrombotic syndrome; pulmonary embolism; duplex scan. ResumoObjetivo: A proposta deste estudo foi realizar a avaliação clínica e ultrassonográfica em longo prazo de pacientes com diagnóstico de trombose venosa profunda (TVP), portadores de trombofilia. Método: estudo coorte, caso-controle retrospectivo com análise transversal. Foram estudados 39 pacientes portadores de trombofilia (PT) e 25 pacientes não portadores de trombofilia (PNT), dentro de um intervalo de tempo de 76,3 ± 45,8 meses, após o diagnóstico de TVP. Foram coletados dados demográficos e antecedentes familiares, assim como dados referentes à evolução clínica e terapêutica, tendo sido realizado também exame físico e ultrassonográfico dos membros envolvidos. Os grupos foram pareados quanto à idade e ao sexo, e as variáveis estudadas foram comparadas entre os grupos. Resultados: TVP foi mais frequente em mulheres. As trombofilias mais comumente encontradas foram a síndrome antifosfolípide e a mutação do fator V Leiden. Não houve diferença entre os grupos considerando-se o número de gestações e abortamentos, e a maioria das mulheres não engravidou após o episódio de TVP. A TVP não espontânea prevaleceu. A TVP proximal e em membro inferior esquerdo foi a mais frequente,...

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Section: Discussioncontrasting

confidence: 58%

Long-term clinical and ultrasonographic evaluation of thrombophilic patients with deep venous thrombosis

et al. 2014

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“…The recurrence rate of venous thromboembolism in the general population (non-APS patients) was quite well defined in 1996 by Prandoni et al [32] who showed a 30% cumulative incidence of recurrence after 8 years of followup (i.e. 3.75% patients per year, in subjects off therapy).…”

Section: Conclusion and Commentsmentioning

confidence: 98%

Thrombotic recurrences and bleeding events in APS vascular patients: A review from the literature and a comparison with the APS Piedmont Cohort

Bazzan

Vaccarino

Stella

et al. 2013

Autoimmunity Reviews

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In APS vascular patients, thrombotic recurrences are more frequent than in non-APS thrombotic patients. To better define this clinical setting, a systematic review of the literature after 1999 was performed: 8 cohort studies (including the recent APS Piedmont Cohort) and 6 intervention studies were selected and evaluated. Thrombotic recurrences, bleeding events, therapeutic strategies, antiphospholipid (aPL) profile, inherited and acquired risk factors (when present) were calculated and compared. Emerging risk factors for thrombotic recurrences include withdrawal of oral anticoagulant therapy (OAT), high intensity OAT (INR range 3-4), aPL profile (triple positivity, Miyakis types 1 and 2a profiles) and association with inherited or acquired pro-thrombotic risk factors. Moreover, there are evidences that high risk (mainly for aPL profile) APS vascular patients have a high recurrence rate in spite of correct OAT treatment. Clinical trials in this clinical setting are needed.

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“…Furthermore, different illnesses carry different associations, cancer being perceived as leading to a lingering, painful death and heart disease being seen as "a good way to go" (Walter et al 2004, Hallowell, in press). In this respect, deep vein thrombosis is close to heart disease, because it usually manifests as an identifiable "event," although the mortality associated with DVT is low (1-2%) in comparison to myocardial infarction, but as many as 25% of patients with DVT will develop a postthrombotic syndrome (associated with chronic pain and other symptoms usually in the leg) and have a significant risk of reoccurrence (up to 30%) over the next 10 years (Prandoni et al 1996).…”

Section: Perceptions Of Genetic Riskmentioning

confidence: 99%

Are genetic tests exceptional? Lessons from a qualitative study on thrombophilia

Saukko

Richards

Shepherd

et al. 2006

Social Science & Medicine

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Policy makers have suggested that information about genetic risk factors, which are associated with low risk and for which preventive strategies exist, should not be considered "exceptional" and should not warrant special safeguards, such as data protection or specialist pre-test counselling. There is scant research on how such risk factors are perceived, and to explore this we conducted qualitative interviews with fortytwo participants, who had undergone testing for a low risk genetic susceptibility to deep vein thrombosis (DVT). Generally the participants thought the test was less serious than a genetic test for a predisposition to breast cancer or a non-genetic, diagnostic test for diabetes. They had used the genetic information to reduce their risk of DVTs by avoiding oral contraceptives and hormone replacement therapy but had not changed their lifestyle.Many participants considered pre-test genetic counselling unnecessary. However, a subgroup of participants, who were often less educated or at a high risk, were distressed and/or confused about thrombophilia and thought pre-test counselling would have been helpful. The findings indicate an emerging interpretation of genetics not as revealing exceptional or "in depth" knowledge about one's health and identity but as occasionally relevant surface information, which participants used to make specific health decisions

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The Long-Term Clinical Course of Acute Deep Venous Thrombosis

Cited by 1,952 publications

References 0 publications

Long-term clinical and ultrasonographic evaluation of thrombophilic patients with deep venous thrombosis

Long-term clinical and ultrasonographic evaluation of thrombophilic patients with deep venous thrombosis

Thrombotic recurrences and bleeding events in APS vascular patients: A review from the literature and a comparison with the APS Piedmont Cohort

Are genetic tests exceptional? Lessons from a qualitative study on thrombophilia

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