Dentali Francesco, Di Minno Matteo Nicola Dario, Turato Sara, Crestani Silvia, Ambrosino Pasquale, Bonfanti Carlo, Di Minno Giovanni, Ageno Walter, Franchini Massimo
Department of Clinical Medicine Insubria University, Varese, Italy.
Department of Clinical Medicine and Surgery, Regional Reference Centre for Coagulation Disorders, "Federico II" University, Naples, Italy.
Thromb Res. 2014 Aug;134(2):264-7. doi: 10.1016/j.thromres.2014.05.016. Epub 2014 May 15.
The presence of residual vein obstruction (RVO) has been consistently associated with an increased risk of post-thrombotic syndrome in patients with a previous deep vein thrombosis (DVT) and there is some evidence suggesting an increased risk of DVT recurrence. Only few studies have assessed potential risk factors for RVO. In this study, we evaluated whether ABO blood group with or without associated thrombophilic abnormalities is associated with RVO after a standard course of anticoagulation for a first DVT. Patients with a first DVT who underwent screening for thrombophilic abnormalities were eligible for this study. Information was collected on ABO blood group and on risk factors for DVT. Each patient underwent compression ultrasonography of the lower limbs for the detection of RVO at least 6months after a standard course of anticoagulant treatment. A total of 268 patients (mean age 50.3years, 120 women) were included. After 8.3±2.9months of anticoagulant treatment, 126 (47.0%) patients had RVO. At multivariate analysis, active malignancy (Odds Ratios [OR] 5.54, 95% confidence interval [CI] 2.17, 14.13), non-O blood group (OR 3.71, 95% CI 1.61, 8.56), and femoral involvement (OR 3.35 95% CI 1.94, 5.78) were significantly associated with RVO whereas an unprovoked index event was only marginally significant (OR 1.81 95% CI 0.98, 3.36 p 0.06) and severe thrombophilia was not associated with RVO (OR 1.32 95% CI 0.56, 3.11). After a standard course of anticoagulation for a first DVT, patients with non-O blood group are at increased risk of RVO.
残余静脉阻塞(RVO)的存在一直与既往有深静脉血栓形成(DVT)的患者发生血栓后综合征的风险增加相关,并且有一些证据表明DVT复发风险增加。仅有少数研究评估了RVO的潜在危险因素。在本研究中,我们评估了伴有或不伴有相关血栓形成倾向异常的ABO血型与首次DVT标准抗凝疗程后RVO是否相关。接受血栓形成倾向异常筛查的首次DVT患者符合本研究条件。收集了ABO血型和DVT危险因素的信息。每位患者在标准抗凝治疗疗程至少6个月后接受下肢加压超声检查以检测RVO。共纳入268例患者(平均年龄50.3岁,女性120例)。抗凝治疗8.3±2.9个月后,126例(47.0%)患者发生RVO。多因素分析显示,活动性恶性肿瘤(比值比[OR] 5.54,95%置信区间[CI] 2.17,14.13)、非O血型(OR 3.71,95% CI 1.61,8.56)和股静脉受累(OR 3.35,95% CI 1.94,5.78)与RVO显著相关,而诱因不明的首发事件仅具有边缘显著性(OR 1.81,95% CI 0.98,3.36,P = 0.06),严重血栓形成倾向与RVO无关(OR 1.32,95% CI 0.56,3.11)。首次DVT标准抗凝疗程后,非O血型患者发生RVO的风险增加。