医学
血栓后综合征
内科学
低分子肝素
深静脉
维生素K拮抗剂
血栓形成
观察研究
荟萃分析
重症监护医学
华法林
心房颤动
作者
Lina Khider,Benjamin Planquette,David Smadja,Olivier Sanchez,Carlos Lojo Rial,Guillaume Goudot,Emmanuel Messas,Tristan Mirault,Nicolas Gendron
标识
DOI:10.1016/j.thromres.2024.04.004
摘要
Abstract
Background
Post-thrombotic syndrome (PTS) is the main long-term complication of deep vein thrombosis (DVT). Several therapies are being evaluated to prevent or to treat PTS. Identifying the patients most likely to benefit from these therapies presents a significant challenge. Objectives
The objective of this review was to identify risk factors for PTS during the acute phase of DVT. Eligibility criteria
We searched the PubMed and Cochrane databases for studies published between January 2000 and January 2021, including randomized clinical trials, meta-analyses, systematic reviews and observational studies. Results
Risk factors for PTS such as proximal location of DVT, obesity, chronic venous disease, history of DVT are associated with higher risk of PTS. On the initial ultrasound-Doppler, a high thrombotic burden appears to be a predictor of PTS. Among the evaluated biomarkers, some inflammatory markers such as ICAM-1, MMP-1 and MMP-8 appear to be associated with a higher risk of developing PTS. Coagulation disorders are not associated with risk of developing PTS. Role of endothelial biomarkers in predicting PTS has been poorly explored. Lastly, vitamin K antagonist was associated with a higher risk of developing PTS when compared to direct oral anticoagulants and low molecular weight heparin. Conclusions
Several risk factors during the acute phase of VTE are associated with an increased risk of developing PTS. There is a high-unmet medical need to identify potential biomarkers for early detection of patients at risk of developing PTS after VTE. Inflammatory and endothelial biomarkers should be explored in larger prospective studies to identify populations that could benefit from new therapies.
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