Division of Cardiology - Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy.
Unit of Cell and Molecular Biology in Cardiovascular Diseases, Centro Cardiologico Monzino, IRCCS, Milan, Italy.
J Thromb Haemost. 2016 May;14(5):964-72. doi: 10.1111/jth.13279. Epub 2016 Mar 15.
Essentials The association of superficial vein thrombosis (SVT) with venous thromboembolism (VTE) is variable. We performed a meta-analysis to assess the prevalence of concomitant VTE in patients with SVT. Deep vein thrombosis was found in 18.1%, and pulmonary embolism in 6.9%, of SVT patients. Screening for VTE may be worthy in some SVT patients to plan adequate anticoagulant treatment.
Background Some studies have suggested that patients with superficial vein thrombosis (SVT) have a non-negligible risk of concomitant deep vein thrombosis (DVT) or pulmonary embolism (PE) at the time of SVT diagnosis. Unfortunately, the available data on this association are widely variable. Objectives To perform a systematic review and meta-analysis of the literature in order to evaluate the prevalence of concomitant DVT/PE in patients with SVT of the lower limbs. Methods Studies reporting on the presence of DVT/PE in SVT patients were systematically searched for in the PubMed, Web of Science, Scopus and EMBASE databases. The weighted mean prevalence (WMP) of DVT and PE was calculated by use of the random effect model. Results Twenty-one studies (4358 patients) evaluated the prevalence of DVT and 11 studies (2484 patients) evaluated the prevalence of PE in patients with SVT. The WMP of DVT at SVT diagnosis was 18.1% (95%CI: 13.9%, 23.3%) and the WMP of PE was 6.9% (95%CI: 3.9%, 11.8%). Heterogeneity among the studies was substantial. Selection of studies including outpatients only gave similar results (WMP of DVT, 18.2%, 95% CI 12.2-26.3%; and WMP of PE, 8.2%, 95% CI 3.3-18.9%). Younger age, female gender, recent trauma and pregnancy were inversely associated with the presence of DVT/PE in SVT patients. Conclusions The results of our large meta-analysis suggest that the prevalence of DVT and PE in patients presenting with SVT is not negligible. Screening for a major thromboembolic event may be worthwhile in some SVT patients, in order to allow adequate anticoagulant treatment to be planned. Other high-quality studies are warranted to confirm our findings.
目的 一些研究表明，下肢浅静脉血栓形成（SVT）患者在 SVT 诊断时存在不容忽视的深静脉血栓形成（DVT）或肺栓塞（PE）合并症风险。不幸的是，关于这种关联的现有数据差异很大。 方法 系统检索 PubMed、Web of Science、Scopus 和 EMBASE 数据库中关于 SVT 患者存在 DVT/PE 的研究。采用随机效应模型计算 DVT 和 PE 的加权均数患病率（WMP）。 结果 21 项研究（4358 例患者）评估了 SVT 患者中 DVT 的患病率，11 项研究（2484 例患者）评估了 SVT 患者中 PE 的患病率。SVT 诊断时 DVT 的 WMP 为 18.1%（95%CI：13.9%，23.3%），PE 的 WMP 为 6.9%（95%CI：3.9%，11.8%）。研究之间存在显著异质性。仅选择包括门诊患者的研究得出了类似的结果（DVT 的 WMP，18.2%，95%CI 12.2-26.3%；PE 的 WMP，8.2%，95%CI 3.3-18.9%）。年龄较小、女性、近期创伤和妊娠与 SVT 患者 DVT/PE 的存在呈负相关。 结论 我们的大型荟萃分析结果表明，SVT 患者中 DVT 和 PE 的患病率不容忽视。在某些 SVT 患者中，筛查是否存在重大血栓栓塞事件可能是值得的，以便能够计划适当的抗凝治疗。需要其他高质量的研究来证实我们的发现。
