Risk of developing post thrombotic syndrome after deep vein thrombosis with different anticoagulant regimens: A systematic review and pooled analysis.

Autor: Brown C; Department of Medicine, The Ottawa Hospital Research Institute at the University of Ottawa, Ottawa, Canada; Faculty of Arts and Science, Queen's University, Kingston, Canada., Tokessy L; Department of Medicine, The Ottawa Hospital Research Institute at the University of Ottawa, Ottawa, Canada; Faculty of Science, University of Ottawa, Ottawa, Canada., Delluc A; Department of Medicine, The Ottawa Hospital Research Institute at the University of Ottawa, Ottawa, Canada., Carrier M; Department of Medicine, The Ottawa Hospital Research Institute at the University of Ottawa, Ottawa, Canada. Electronic address: mcarrier@toh.ca.
Jazyk: angličtina
Zdroj: Thrombosis research [Thromb Res] 2024 Aug; Vol. 240, pp. 109057. Date of Electronic Publication: 2024 Jun 03.
DOI: 10.1016/j.thromres.2024.109057
Abstrakt: Background: Post-thrombotic syndrome (PTS) is common in patients with deep vein thrombosis (DVT). It is unclear if different types of anticoagulant therapies (e.g. vitamin K antagonists (VKA), direct oral anticoagulants (DOACs) or low molecular weight heparin (LMWH)) are associated with different risks of PTS. We sought to assess the incidence rates of PTS development following a proximal DVT of the lower extremity managed with different types of anticoagulation regimens.
Methods: A systematic search of MEDLINE, EMBASE and PubMed, from inception to June 2023 was performed. The primary outcome was development of PTS. The secondary outcomes included severe PTS, venous ulcers, and major bleeding. Incidence rates were pooled using the random effects model and expressed as event per 100 patient-years with its associated 95 % confidence intervals (CI) using R software.
Results: A total of 21 (4342 patients) articles were included in the analysis. The adjusted pooled incidence of PTS was 15.1 (95 % CI: 8.7 to 26.1), 18.2 (95 % CI: 9.4 to 35.1) and 24.6 (95 % CI: 9.2 to 65.5) per 100 patient-years patients managed with VKA, DOAC and LMWH, respectively. The adjusted pooled incidence of severe PTS was 5.1 (95 % CI: 2.6 to 10.0) and 0.2 (95 % CI: 0.01 to 2.7) per 100 patient-years for VKAs and DOACs, respectively.
Conclusions: The development of PTS is common in patients with proximal lower extremity DVT. The incidence rates of PTS seem to be similar across the different anticoagulation regimens, but severe PTS may be lower among patients receiving a DOAC.
Competing Interests: Declaration of competing interest M. Carrier has received research funding from BMS, Pfizer, and Leo Pharma, and honoraria from Bayer, Pfizer, BMS, Servier, and Leo Pharma. A. Delluc reports grants from Leo Pharma and Pfizer, personal fees from BMS, Leo Pharma, Pfizer, Servier. C Brown and L Tokessy have no relevant conflicts of interest to disclose.
(Copyright © 2024 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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