Key result
Proximal DVT, obesity, chronic venous disease, prior DVT, high thrombotic burden, inflammatory markers, and vitamin K antagonists are associated with a higher risk of developing post-thrombotic syndrome.
Why the study?
Post-thrombotic syndrome is the main long-term complication of DVT, and identifying patients most likely to benefit from preventive or therapeutic interventions is a significant challenge.
What are the risk factors for developing post-thrombotic syndrome during the acute phase of deep vein thrombosis?
What are the risk factors for developing post-thrombotic syndrome during the acute phase of deep vein thrombosis?
Several clinical, imaging, and biomarker risk factors during the acute phase of DVT can help identify patients at high risk for developing post-thrombotic syndrome.
Answers are grounded in this paper and cite their sources.
May aid risk stratification in acute DVT; leaves open need for prospective validation before guiding care.
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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Khider et al. (2024) conducted a review in Deep vein thrombosis (DVT) / Post-thrombotic syndrome (PTS). Acute phase risk factors (proximal DVT, obesity, chronic venous disease, history of DVT, high thrombotic burden, inflammatory markers, VKA) was evaluated on Post-thrombotic syndrome (PTS). Proximal DVT, obesity, chronic venous disease, prior DVT, high thrombotic burden, inflammatory markers, and vitamin K antagonists are associated with a higher risk of developing post-thrombotic syndrome.
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