Levels of inflammatory markers and the development of the post-thrombotic syndrome

Shbaklo, Hadia; Holcroft, Christina; Kahn, Susan R.

doi:10.1160/th08-08-0511

Cited by 100 publications

(65 citation statements)

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“…18,35 Sustained venous hypertension can cause structural and biochemical abnormalities of the vein wall, resulting in pathological effects in the skin and subcutaneous tissues such as edema, hyperpigmentation, varicose veins, and ulceration. 24 Several studies have reported associations between elevated levels of various inflammation markers and PTS development 35,36 (see Role of Biomarkers to Predict PTS).…”

Section: Clinical Manifestations and Pathophysiology Characteristic Smentioning

confidence: 99%

“…Shbaklo et al 36 reported that patients with PTS had significantly higher mean levels of interleukin-6 and intercellular adhesion molecule-1 than those without PTS. Roumen-Klappe et al 35 noted that higher levels of interleukin-6 and C-reactive protein were associated with greater venous outflow resistance 3 months after DVT, but their association with clinical PTS was weak or absent.…”

Section: Role Of Biomarkers To Predict Ptsmentioning

confidence: 99%

See 1 more Smart Citation

The Postthrombotic Syndrome: Evidence-Based Prevention, Diagnosis, and Treatment Strategies

Kahn¹,

Comerota²,

Cushman³

et al. 2014

Circulation

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499

410

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Section: Clinical Manifestations and Pathophysiology Characteristic Smentioning

confidence: 99%

Section: Role Of Biomarkers To Predict Ptsmentioning

confidence: 99%

The Postthrombotic Syndrome: Evidence-Based Prevention, Diagnosis, and Treatment Strategies

Kahn¹,

Comerota²,

Cushman³

et al. 2014

Circulation

Self Cite

499

410

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“…The inflammatory response elicited after a thrombotic event is needed for resolution of the thrombus. 29 We speculate that this physiological response may contribute to disruption of the blood-retina barrier and formation of oedema due to the action on tight junctions mentioned earlier.…”

Section: Il-8 and Mcp-1 In Brvo Macular Oedemamentioning

confidence: 63%

Vitreous levels of interleukine-8 and monocyte chemoattractant protein-1 in macular oedema with branch retinal vein occlusion

Fonollosa¹,

García-Arumí

Santos

et al. 2010

Eye

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Purpose To investigate whether interleukine-8 (IL-8) and monocyte chemoattractant protein-1 (MCP-1) are related with macular oedema in patients with branch retinal vein occlusions (BRVOs). Design Retrospective case-control study. Participants Nineteen patients who had macular oedema due to BRVO and nine patients with non-ischaemic ocular diseases (control group). Methods Macular oedema was examined by optical coherence tomography. Both venous blood and vitreous samples were obtained at the time of vitreoretinal surgery. IL-8 and MCP-1 levels in vitreous fluid and plasma were determined with enzyme-linked immunosorbent assay kits. Variables were compared with the Mann-Whitney U-test, Wilcoxon's signed-ranked test, and the v 2 -test, when appropriate. To examine correlations, Spearman's rank-order correlation coefficients were calculated. Statistical significance was set at Po0.05. Results The vitreous fluid levels of IL-8 (median: 63.5 pg/ml) and MCP-1 (median: 1522.4 pg/ml) were significantly higher in the patients with BRVO than in the control group (median: 5.1 and 746.5 pg/ml respectively; Po0.001 and o0.001 respectively). Vitreous IL-8 and MCP-1 were significantly correlated in patients with BRVO (P ¼ 0.009). Conclusions Both IL-8 and MCP-1 were elevated in the vitreous fluid of patients with BRVO and macular oedema. Both chemokines may contribute to the pathogenesis of macular oedema in patients with BRVO.

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“…With regard to biomarkers that could help to predict PTS, recent studies have reported that elevated levels of markers of inflammation (eg, ICAM-1, interleukin-6, and C-reactive protein) 49,50 and D-dimer 40,51 early after diagnosis or within a few months of DVT were associated with the development of PTS. A large, prospective multicenter study that is examining the predictive role of various markers of inflammation, D-dimer, and thrombophilia in the development of PTS is currently under way.…”

Section: Individual Risk Factors For Ptsmentioning

confidence: 99%

How I treat postthrombotic syndrome

Kahn

2009

Blood

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146

112

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Postthrombotic syndrome (PTS) is a chronic complication of deep venous thrombosis (DVT) that reduces quality of life and has important socioeconomic consequences. More than one-third of patients with DVT will develop PTS, and 5% to 10% of patients will develop severe PTS, which may manifest as venous ulceration. The principal risk factors for PTS are persistent leg symptoms 1 month after the acute episode of DVT, extensive DVT, recurrent ipsilateral DVT, obesity, and older age. Daily use of elastic compression stockings (ECSs) for 2 years after proximal DVT appears to reduce the risk of PTS; however, there is uncertainty about optimal duration of use and compression strength of ECSs and the magnitude of their effect. The cornerstone of managing PTS is compression therapy, primarily using ECSs. IntroductionDeep vein thrombosis (DVT) is a common vascular condition that is associated with significant rates of morbidity and mortality. Although pulmonary embolism and recurrent venous thrombosis are well-known consequences of DVT, an important, underappreciated, chronic consequence of DVT is postthrombotic syndrome (PTS). PTS develops in 20% to 50% of patients with DVT, 1,2 even when appropriate anticoagulant therapy is prescribed to treat the DVT. On the basis of its high incidence and prevalence, PTS is the single most frequent complication of DVT.Some practitioners may believe that PTS is primarily a cosmetic or "nuisance" problem. To the contrary, PTS is burdensome and potentially debilitating to patients, and it is a condition for which patients frequently seek medical advice. Manifestations of PTS vary from mild clinical symptoms or signs to more severe manifestations such as chronic leg pain that limits activity and ability to work, intractable edema, and leg ulcers. 3 PTS has been shown to have significant, adverse effects on quality of life and productivity, [4][5][6] and is costly as measured by health resource utilization, direct costs, and indirect costs. [7][8][9] In this review, I address the following questions: (1) How is PTS diagnosed? (2) Can we identify patients with DVT who are at risk of developing PTS? (3) How can PTS be prevented? (4) How do I treat PTS? and (5) What are the gaps in our understanding of PTS that should be addressed by future research? I also address upper-extremity PTS and the responsibility to discuss long-term prognosis with patients with DVT. This paper focuses on PTS in adults. Readers with an interest in PTS in children are referred to a recent review of this topic. 10 How I diagnose PTS Clinical presentation of PTSPTS is termed a "syndrome" because it is associated with groupings of symptoms and clinical signs that typically vary from patient to patient (Table 1). Patients with PTS experience aching pain, heaviness, swelling, cramps, itching, or tingling in the affected limb. Symptoms may be present in various combinations and may be persistent or intermittent. Typically, symptoms are aggravated by standing or walking and improve with resting, leg elevation, and lying dow...

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Levels of inflammatory markers and the development of the post-thrombotic syndrome

Cited by 100 publications

References 46 publications

The Postthrombotic Syndrome: Evidence-Based Prevention, Diagnosis, and Treatment Strategies

The Postthrombotic Syndrome: Evidence-Based Prevention, Diagnosis, and Treatment Strategies

Vitreous levels of interleukine-8 and monocyte chemoattractant protein-1 in macular oedema with branch retinal vein occlusion

How I treat postthrombotic syndrome

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