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Risk factors for post-thrombotic syndrome in patients with deep vein thrombosis: from the COMMAND VTE registry

  • Yuji Nishimoto
  • Yugo Yamashita
  • Takeshi Morimoto
  • Syunsuke Saga
  • Hidewo Amano
  • Toru Takase
  • Seiichi Hiramori
  • Kitae Kim
  • Maki Oi
  • Masaharu Akao
  • Yohei Kobayashi
  • Mamoru Toyofuku
  • Toshiaki Izumi
  • Tomohisa Tada
  • Po-Min Chen
  • Koichiro Murata
  • Yoshiaki Tsuyuki
  • Tomoki Sasa
  • Jiro Sakamoto
  • Minako Kinoshita
  • Kiyonori Togi
  • Hiroshi Mabuchi
  • Kensuke Takabayashi
  • Hiroki Shiomi
  • Takao Kato
  • Takeru Makiyama
  • Koh Ono
  • Yukihito Sato
  • Takeshi Kimura
  • The COMMAND VTE Registry Investigators
Original Article
  • 66 Downloads

Abstract

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.

Keywords

Deep vein thrombosis Venous thromboembolism Post-thrombotic syndrome Risk factors 

Notes

Acknowledgements

We appreciate the support and collaboration of the co-investigators participating in the COMMAND VTE Registry. We are indebted to the independent clinical research organization (Research Institute for Production Development, Kyoto, Japan) for technical support. We also would like to express our gratitude to Mr. John Martin for his grammatical assistance.

Funding

The COMMAND VTE Registry is supported by the independent clinical research organization (Research Institute for Production Development, Kyoto, Japan) and research funding from Mitsubishi Tanabe Pharma Corporation. The research funding had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.

Conflicts of interest

Dr. Yamashita received lecture fees from Daiichi-Sankyo, Bristol-Myers Squibb, and Bayer Healthcare. Dr. Morimoto received lecture fees from Mitsubishi Tanabe Pharma and Pfizer Japan and consultant fees from Asahi Kasei, Bristol-Myers Squibb, and Boston Scientific. Dr. Akao received lecture fees from Pfizer, Bristol-Myers Squibb, Boehringer Ingelheim, Bayer Healthcare and Daiichi-Sankyo. Dr. Kimura serves as an advisory board member for Abbott Vascular and Terumo Company. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Supplementary material

380_2018_1277_MOESM1_ESM.docx (30 kb)
Supplementary file1 (DOCX 29 kb)

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Copyright information

© Springer Japan KK, part of Springer Nature 2018

Authors and Affiliations

  • Yuji Nishimoto
    • 1
  • Yugo Yamashita
    • 2
  • Takeshi Morimoto
    • 3
  • Syunsuke Saga
    • 1
  • Hidewo Amano
    • 4
  • Toru Takase
    • 5
  • Seiichi Hiramori
    • 6
  • Kitae Kim
    • 7
  • Maki Oi
    • 8
  • Masaharu Akao
    • 9
  • Yohei Kobayashi
    • 10
  • Mamoru Toyofuku
    • 11
  • Toshiaki Izumi
    • 12
  • Tomohisa Tada
    • 13
  • Po-Min Chen
    • 14
  • Koichiro Murata
    • 15
  • Yoshiaki Tsuyuki
    • 16
  • Tomoki Sasa
    • 17
  • Jiro Sakamoto
    • 18
  • Minako Kinoshita
    • 19
  • Kiyonori Togi
    • 20
  • Hiroshi Mabuchi
    • 21
  • Kensuke Takabayashi
    • 22
  • Hiroki Shiomi
    • 2
  • Takao Kato
    • 2
  • Takeru Makiyama
    • 2
  • Koh Ono
    • 2
  • Yukihito Sato
    • 1
  • Takeshi Kimura
    • 2
  • The COMMAND VTE Registry Investigators
  1. 1.Department of CardiologyHyogo Prefectural Amagasaki General Medical CenterAmagasakiJapan
  2. 2.Department of Cardiovascular Medicine, Graduate School of MedicineKyoto UniversityKyotoJapan
  3. 3.Department of Clinical EpidemiologyHyogo College of MedicineNishinomiyaJapan
  4. 4.Department of Cardiovascular MedicineKurashiki Central HospitalKurashikiJapan
  5. 5.Department of CardiologyKinki University HospitalOsakaJapan
  6. 6.Department of CardiologyKokura Memorial HospitalKokuraJapan
  7. 7.Department of Cardiovascular MedicineKobe City Medical Center General HospitalKobeJapan
  8. 8.Department of CardiologyJapanese Red Cross Otsu HospitalOtsuJapan
  9. 9.Department of CardiologyNational Hospital Organization Kyoto Medical CenterKyotoJapan
  10. 10.Department of Cardiovascular CenterOsaka Red Cross HospitalOsakaJapan
  11. 11.Department of CardiologyJapanese Red Cross Wakayama Medical CenterWakayamaJapan
  12. 12.Cardiovascular CenterThe Tazuke Kofukai Medical Research Institute, Kitano HospitalOsakaJapan
  13. 13.Department of CardiologyShizuoka General HospitalShizuokaJapan
  14. 14.Department of CardiologyOsaka Saiseikai Noe HospitalOsakaJapan
  15. 15.Department of CardiologyShizuoka City Shizuoka HospitalShizuokaJapan
  16. 16.Division of CardiologyShimada Municipal HospitalShimadaJapan
  17. 17.Department of CardiologyKishiwada City HospitalKishiwadaJapan
  18. 18.Department of CardiologyTenri HospitalTenriJapan
  19. 19.Department of CardiologyNishikobe Medical CenterKobeJapan
  20. 20.Division of Cardiology, Faculty of MedicineNara Hospital, Kinki UniversityIkomaJapan
  21. 21.Department of CardiologyKoto Memorial HospitalHigashiomiJapan
  22. 22.Department of CardiologyHirakata Kohsai HospitalHirakataJapan

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