Risk of post-thrombotic syndrome after subtherapeutic warfarin anticoagulation for a first unprovoked deep vein thrombosis: results from the REVERSE study

被引：104

作者：

Chitsike, R. S. ^{[1
]}

Rodger, M. A. ^{[2
,3
]}

Kovacs, M. J. ^{[4
]}

Betancourt, M. T. ^{[2
,3
]}

Wells, P. S. ^{[2
,3
]}

Anderson, D. R. ^{[5
]}

Chagnon, I. ^{[6
]}

Le Gal, G. ^{[7
,8
]}

Solymoss, S. ^{[9
]}

Crowther, M. A. ^{[10
]}

Perrier, A. ^{[11
]}

White, R. H. ^{[12
]}

Vickars, L. M. ^{[13
]}

Ramsay, T. ^{[2
,3
]}

Kahn, S. R. ^{[1
,9
]}

机构：

[1] McGill Univ, Jewish Gen Hosp, Ctr Clin Epidemiol & Community Studies, Montreal, PQ H3T 1E2, Canada

[2] Univ Ottawa, Dept Med, Div Hematol, Thrombosis Program, Ottawa, ON, Canada

[3] Ottawa Hosp, Ottawa Hlth Res Inst, Clin Epidemiol Unit, Ottawa, ON, Canada

[4] Univ Western Ontario, Dept Med, Div Hematol, London, ON, Canada

[5] Dalhousie Univ, Dept Med, Halifax, NS, Canada

[6] Univ Montreal, Dept Med, Hop Sacre Coeur Montreal, Montreal, PQ H3C 3J7, Canada

[7] Univ Hosp, Brest, France

[8] Dept Internal Med & Chest Dis, Brest, France

[9] McGill Univ, Dept Med, Montreal, PQ, Canada

[10] McMaster Univ, Dept Med, Michael G DeGroote Sch Med, Hamilton, ON, Canada

[11] Univ Hosp Geneva, Fac Med, Dept Internal Med, Geneva, Switzerland

[12] UC Davis Sch Med, Dept Med, Sacramento, CA USA

[13] Univ British Columbia, Dept Med, St Pauls Hosp, Vancouver, BC, Canada

来源：

JOURNAL OF THROMBOSIS AND HAEMOSTASIS | 2012年 / 10卷 / 10期

基金：

加拿大健康研究院;

关键词：

anticoagulation; post-thrombotic syndrome; risk factor; venous thrombosis; warfarin; VENOUS THROMBOSIS; ATRIAL-FIBRILLATION; ORAL ANTICOAGULANT; THERAPY; THROMBOEMBOLISM; DETERMINANTS; QUALITY; RECURRENCE; INTENSITY; TIME;

D O I：

10.1111/j.1538-7836.2012.04872.x

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

. Background: Risk factors for post-thrombotic syndrome (PTS) remain poorly understood. Objectives: In this multinational multicenter study, we evaluated whether subtherapeutic warfarin anticoagulation was associated with the development of PTS. Methods: Patients with a first unprovoked deep venous thrombosis (DVT) received standard anticoagulation for 57 months and were then assessed for PTS. The time in the therapeutic range was calculated from the international normalized ratio (INR) data. An INR below 2, more than 20% of the time, was considered as subtherapeutic anticoagulation. Results: Of the 349 patients enrolled, 97 (28%) developed PTS. The overall frequency of PTS in patients with subtherapeutic anticoagulation was 33.5%, compared with 21.6% in those with an INR below two for = 20% of the time (P = 0.01). During the first 3 months of therapy, the odds ratio (OR) for developing PTS if a patient had subtherapeutic anticoagulation was 1.78 (95% confidence interval [CI] 1.102.87). After adjusting for confounding variables, the OR was 1.84 (95% CI 1.133.01). Corresponding ORs for the full period of anticoagulation were 1.83 (95% CI 1.143.00) [crude] and 1.88 (95% CI 1.153.07) [adjusted]. Conclusion: Subtherapeutic warfarin anticoagulation after a first unprovoked DVT was significantly associated with the development of PTS.

引用

页码：2039 / 2044

页数：6

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