Matsuo Hiroshi, Matsumura Makoto, Nakajima Yoshie, Ogawa Tomohiro, Tazaki Junichi, Doi Takahiro, Yamada Norikazu, Koide Takashi, Mo Makoto, Suzuki Takeo, Sarai Nobuaki, Nakajima Hiromu
Matsuo Vascular Ultrasound Laboratory, Matsuo Clinic, Suita, Osaka, Japan.
Department of Cardiology, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan.
J Cardiol. 2014 Dec;64(6):430-4. doi: 10.1016/j.jjcc.2014.02.028. Epub 2014 Apr 20.
Congestive heart failure (CHF) is one of the risk factors for deep vein thrombosis (DVT) according to the Japanese guidelines for DVT treatment and prevention. The purpose of this study is to estimate the frequency of DVT among hospitalized CHF patients, since there have been only limited DVT data in Japanese CHF patients.
Patients enrolled in the study were with risk factors for DVT listed in the guidelines as well as with acute exacerbation of CHF, bed rest for at least 4 days, and aged 60 or above. Patients treated by physical prophylaxis or anti-platelet medication were included, while patients treated by any anticoagulant medicines were excluded. Patients with surgery or injury within 3 months before the hospitalization or diagnosed clinically or with obvious past history as having DVT at hospitalization were excluded. The presence of DVT in the eligible patients was determined by ultrasonography and the images were evaluated by an independent central evaluation committee.
Forty-four patients were enrolled in the study including 19 males and 25 females. The mean age was 79.0±10.6 years, and the mean duration of bed rest was 8.9±3.2 days. Out of these 44 patients, DVT was detected in 15 (34%) patients. Eight patients were on treatment with physical prophylaxis but DVT was still detected in two patients. Furthermore, 12 out of the rest of the patients were treated by anti-platelet agents and were still with DVT in 3 patients.
When evaluated ultrasonographically, the frequency of DVT in hospitalized non-surgical Japanese patients with CHF was approximately 35%. DVT occurred in 25% of patients treated by physical prophylaxis or anti-platelet agents. The results suggest that Japanese hospitalized patients with CHF have a high risk of DVT and thus can be recognized to have potential benefit by preventing and treating DVT according to the guidelines.
根据日本深静脉血栓形成(DVT)治疗与预防指南,充血性心力衰竭(CHF)是DVT的危险因素之一。本研究旨在评估住院CHF患者中DVT的发生频率,因为日本CHF患者的DVT数据有限。
纳入本研究的患者具有指南中列出的DVT危险因素,以及CHF急性加重、至少卧床休息4天且年龄在60岁及以上。接受物理预防或抗血小板药物治疗的患者被纳入,而接受任何抗凝药物治疗的患者被排除。住院前3个月内有手术或损伤史,或住院时临床诊断或有明显既往史诊断为DVT的患者被排除。通过超声检查确定符合条件患者中DVT的存在,并由独立的中央评估委员会对图像进行评估。
44例患者纳入本研究,其中男性19例,女性25例。平均年龄为79.0±10.6岁,平均卧床休息时间为8.9±3.2天。在这44例患者中,15例(34%)检测到DVT。8例患者接受物理预防治疗,但仍有2例检测到DVT。此外,其余患者中有12例接受抗血小板药物治疗,其中3例仍有DVT。
经超声评估,住院的非手术日本CHF患者中DVT的发生频率约为35%。接受物理预防或抗血小板药物治疗的患者中25%发生了DVT。结果表明,日本住院CHF患者发生DVT的风险较高,因此根据指南预防和治疗DVT可能具有潜在益处。