Key result
Elevated baseline levels of D-dimers strongly predicted the development of venous thrombosis after pacemaker implantation (OR 590.5).
Why the study?
Do changes in thrombotic and inflammatory factors predict the incidence of venous thrombosis after pacemaker implantation?
Observational (n=81)
No
Do changes in thrombotic and inflammatory factors predict the incidence of venous thrombosis after pacemaker implantation?
Baseline D-dimer elevation may identify high-risk patients for post-pacemaker venous thrombosis; hypothesis-generating and should not yet change practice.
INTRODUCTION: Thrombosis (VTh) is a rare dangerous complication of pacemaker implantation (PM). The aim of the study was to determine the dynamics of change in selected thrombotic and inflammatory factors after PM. MATERIAL AND METHODS: The study involved 81 patients (30 female, mean age: 71.1 years) with PM, divided into two groups. Group A (71 patients) consisted of patients without VTh, whereas group B (10 patients) comprised the patients with VTh. A transthoracic echocardiogram (TTE) and a venous ultrasound (VU) examination were performed. The levels of D-dimers, fibrinogen, tissue factor (TF), factor VII, plasminogen activator inhibitor-1 (PAI-1), interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hsCRP) were determined in the venous blood. After PM, the TTE and VU examinations were repeated at 6 and 12 months, and blood analyses were performed within 7 days after PM, and subsequently at 6 and 12 months. RESULTS: In 10 patients of group B, symptomatic VTh occurred at a mean time of 13.06 months after PM. Initially, the levels of IL-6, hsCRP, D-dimers, fibrinogen, TF, VII factor and PAI-1 were considerably higher in group B than in group A. In all patients the levels of these factors kept on increasing for up to 7 days after the procedure. In group A they subsequently decreased, whereas in group B they continued to rise. CONCLUSIONS: Increased levels of inflammatory and thrombotic factors were observed in patients with VTh before and after PM. The factors of highest risk of VTh occurrence were D-dimers, fibrinogen and TF.
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Lelakowski et al. (2012) conducted an observational in Venous thrombosis after pacemaker implantation (n=81). Pacemaker implantation vs. Patients without venous thrombosis was evaluated on Venous thrombosis prediction by D-dimers (OR 590.5, 95% CI 40.203-24760, p=0.001). Elevated baseline levels of D-dimers strongly predicted the development of venous thrombosis after pacemaker implantation (OR 590.5).
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