Exploring phenotypes of deep vein thrombosis in relation to clinical outcomes beyond recurrence

Iding, Aaron F.J.; Robles, Alejandro Pallares; Cate, Vincent ten; Cate, Hugo Ten; Wild, Philipp S.; Cate‐Hoek, Arina J. ten

doi:10.1016/j.jtha.2023.01.025

Cited by 10 publications

(7 citation statements)

References 34 publications

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“…In this study, male OR = 1.189 (95%CI; 0.780–1.812) was not a risk factor of PTS. Meanwhile, Iding AFJ et al, 2023 ( 33 ) noted in their study that estrogen use in women reduces the incidence of PTS, so further research is needed to determine whether gender can be used as an independent predictor. Unprovoked DVT is DVT occurring in the absence of a transient risk factor.…”

Section: Discussionmentioning

confidence: 99%

A systematic evaluation and meta-analysis of early prediction of post-thrombotic syndrome

Yu,

Song,

et al. 2023

Front. Cardiovasc. Med.

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ObjectivePost-thrombotic syndrome (PTS) is the most common long-term complication in patients with deep venous thrombosis, and the prevention of PTS remains a major challenge in clinical practice. Some studies have explored early predictors and constructed corresponding prediction models, whereas their specific application and predictive value are controversial. Therefore, we conducted this systematic evaluation and meta-analysis to investigate the incidence of PTS and the feasibility of early prediction.MethodsWe systematically searched databases of PubMed, Embase, Cochrane and Web of Science up to April 7, 2023. Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of the included articles, and the OR values of the predictors in multi-factor logistic regression were pooled to assess whether they could be used as effective independent predictors.ResultsWe systematically included 20 articles involving 8,512 subjects, with a predominant onset of PTS between 6 and 72 months, with a 2-year incidence of 37.5% (95% CI: 27.8–47.7%). The results for the early predictors were as follows: old age OR = 1.840 (95% CI: 1.410–2.402), obesity or overweight OR = 1.721 (95% CI: 1.245–2.378), proximal deep vein thrombosis OR = 2.335 (95% CI: 1.855–2.938), history of venous thromboembolism OR = 3.593 (95% CI: 1.738–7.240), history of smoking OR = 2.051 (95% CI: 1.305–3.224), varicose veins OR = 2.405 (95% CI: 1.344–4.304), and baseline Villalta score OR = 1.095(95% CI: 1.056–1.135). Meanwhile, gender, unprovoked DVT and insufficient anticoagulation were not independent predictors. Seven studies constructed risk prediction models. In the training set, the c-index of the prediction models was 0.77 (95% CI: 0.74–0.80) with a sensitivity of 0.75 (95% CI: 0.68–0.81) and specificity of 0.69 (95% CI: 0.60–0.77). In the validation set, the c-index, sensitivity and specificity of the prediction models were 0.74(95% CI: 0.69–0.79), 0.71(95% CI: 0.64–0.78) and 0.72(95% CI: 0.67–0.76), respectively.ConclusionsWith a high incidence after venous thrombosis, PTS is a complication that cannot be ignored in patients with venous thrombosis. Risk prediction scoring based on early model construction is a feasible option, which helps to identify the patient's condition and develop an individualized prevention program to reduce the risk of PTS.

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Section: Discussionmentioning

confidence: 99%

A systematic evaluation and meta-analysis of early prediction of post-thrombotic syndrome

Yu,

Song,

et al. 2023

Front. Cardiovasc. Med.

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“…While residual vein thrombosis has no role in patient management according to actual international guidelines, a study by Iding et al 14 found that residual obstruction after deep vein thrombosis (DVT) indicated a higher risk of postthrombotic syndrome which might prompt discussions on personalized care for VTE patients. 15 Interestingly, the authors also observed higher risk of arterial events, hinting at shared underlying mechanisms between venous fibrosis and atherosclerosis.…”

Section: Working Against the Clotmentioning

confidence: 99%

Thrombosis and Haemostasis 2023 Editors' Choice Papers

Weber,

Rigby,

Lip

2024

Thromb Haemost

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“…In a single-center, prospective study including consecutive patients with symptomatic proximal deep vein thrombosis described in the paper by Iding et al in this journal tested a management strategy with duration of anticoagulation tailored to residual thrombosis and to the setting of the thrombotic event (provoked or unprovoked). 12 Patients with persistent risk factors for venous thromboembolism were excluded from the study. The authors found no association between residual thrombosis and recurrent venous thromboembolism after adjusting for duration of anticoagulant therapy, unprovoked deep vein thrombosis, previous venous thromboembolism, venous insufficiency, and hypertension.…”

mentioning

confidence: 99%

“…The management strategy tested by Iding et al tailored anticoagulation to residual thrombosis in both, patients treated for provoked and unprovoked deep vein thrombosis. 12 A large amount of data exist showing that the setting of index venous thromboembolism can be used to efficiently classify patients according to the risk for recurrence. The highest the attributable risk of the trigger condition for index venous thromboembolism (as major surgery and major trauma), the lower the risk for recurrent venous thromboembolism beyond discontinuation of anticoagulant treatment.…”

mentioning

confidence: 99%

“…By including patients treated for deep vein thrombosis associated with transient risk factors, Iding et al suggest that these patients could be candidates for further risk stratification. 12 Risk stratification was initially proposed for patients suffering from venous thromboembolism not associated with identifiable risk factors but has been recently proposed also for patients having venous thromboembolism in the context of minor risk factors. Pursuing personalized medicine, several predictors have been proposed to stratify the risk for recurrence.…”

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confidence: 99%

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Residual Thrombosis: Still Relevant in the Direct Oral Anticoagulant (DOAC) Era?

Becattini

Agnelli

2023

Thromb Haemost

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Exploring phenotypes of deep vein thrombosis in relation to clinical outcomes beyond recurrence

Cited by 10 publications

References 34 publications

A systematic evaluation and meta-analysis of early prediction of post-thrombotic syndrome

A systematic evaluation and meta-analysis of early prediction of post-thrombotic syndrome

Thrombosis and Haemostasis 2023 Editors' Choice Papers

Residual Thrombosis: Still Relevant in the Direct Oral Anticoagulant (DOAC) Era?

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