Nishimoto Yuji, Yamashita Yugo, Morimoto Takeshi, Saga Syunsuke, Amano Hidewo, Takase Toru, Hiramori Seiichi, Kim Kitae, Oi Maki, Akao Masaharu, Kobayashi Yohei, Toyofuku Mamoru, Izumi Toshiaki, Tada Tomohisa, Chen Po-Min, Murata Koichiro, Tsuyuki Yoshiaki, Sasa Tomoki, Sakamoto Jiro, Kinoshita Minako, Togi Kiyonori, Mabuchi Hiroshi, Takabayashi Kensuke, Shiomi Hiroki, Kato Takao, Makiyama Takeru, Ono Koh, Sato Yukihito, Kimura Takeshi
Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan.
Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
Heart Vessels. 2019 Apr;34(4):669-677. doi: 10.1007/s00380-018-1277-3. Epub 2018 Oct 6.
Post-thrombotic syndrome (PTS) is the most common chronic complication of deep vein thrombosis (DVT). Identifying high-risk patients for the development of PTS might be useful for its prevention. The COMMAND VTE Registry is a multicenter registry that enrolled 3027 consecutive patients with acute symptomatic venous thromboembolisms (VTEs) in Japan between January 2010 and August 2014. The current study population consisted of 1298 patients with lower extremities DVTs who completed 3-year follow-up for those who developed PTS and those without PTS. We investigated risk factors for the development of PTS at the time of DVT diagnosis, using a multivariable logistic regression analysis. Of the entire 1298 study patients, 169 (13%) patients were diagnosed with PTS within 3 years. The rate for anticoagulation discontinuation during follow-up was not significantly different between those with and without PTS. Chronic kidney disease (OR 2.21, 95% CI 1.45-3.39, P < 0.001), leg swelling (OR 4.15, 95% CI 2.25-7.66, P < 0.001), absence of transient risk factors for VTEs (OR 2.39, 95% CI 1.55-3.67, P < 0.001), active cancer (OR 3.66, 95% CI 2.30-5.84, P < 0.001), and thrombophilia (OR 2.07, 95% CI 1.06-4.04, P = 0.03) were independent risk factors for the development of PTS. In this real-world Japanese DVT registry, we could identify several important risk factors for the development of PTS at the time of DVT diagnosis.
血栓形成后综合征（PTS）是深静脉血栓形成（DVT）最常见的慢性并发症。识别PTS发生的高危患者可能对其预防有用。COMMAND VTE注册研究是一项多中心注册研究，在2010年1月至2014年8月期间，连续纳入了日本3027例急性症状性静脉血栓栓塞症（VTE）患者。当前的研究人群包括1298例下肢DVT患者，这些患者对发生PTS和未发生PTS的患者均完成了3年随访。我们使用多变量逻辑回归分析，调查了DVT诊断时PTS发生的危险因素。在全部1298例研究患者中，169例（13%）患者在3年内被诊断为PTS。有PTS和无PTS患者在随访期间抗凝治疗中断率无显著差异。慢性肾脏病（比值比[OR]2.21，95%置信区间[CI]1.45 - 3.39，P＜0.001）、腿部肿胀（OR 4.15，95% CI 2.25 - 7.66，P＜0.001）、无VTE的短暂危险因素（OR 2.39，95% CI 1.5 – 3.67，P＜0.001）、活动性癌症（OR 3.66，95% CI 2.30 - 5.84，P＜0.001）和血栓形成倾向（OR 2.07，95% CI 1.06 - 4.04，P = 0.03）是PTS发生的独立危险因素。在这个真实世界的日本DVT注册研究中，我们能够识别出DVT诊断时PTS发生的几个重要危险因素。
