Risk factors for post-thrombotic syndrome in patients with deep vein thrombosis: from the COMMAND VTE registry
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.
KeywordsDeep vein thrombosis Venous thromboembolism Post-thrombotic syndrome Risk factors
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.
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.
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