Paolo Prandoni1, Maurizio Ciammaichella2, Nicola Mumoli3, Nello Zanatta4, Adriana Visonà5, Giampiero Avruscio6, Giuseppe Camporese6, Eugenio Bucherini7, Carlo Bova8, Davide Imberti9, Raffaella Benedetti9, Valeria Rossetto10, Franco Noventa11, Marta Milan11. 1. Department of Cardiovascular Sciences, Vascular Medicine Unit, University of Padua, Italy. Electronic address: paoloprandoni@tin.it. 2. Department of Emergency, A.O. San Giovanni-Addolorata, Roma, Italy. 3. Department of Internal Medicine, Civic Hospital of Livorno, Italy. 4. Division of General Medicine, Presidio Hospital of Conegliano Veneto, Italy. 5. Department of Angiology, S. Giacomo Apostolo Hospital, Castelfranco, Italy. 6. Department of Cardiovascular Sciences, Angiology Unit, University of Padua, Italy. 7. Department of Vascular Medicine, Hospital of Ravenna-Faenza, Italy. 8. Division of Internal Medicine, Civic Hospital of Cosenza, Italy. 9. Haemostasis and Thrombosis Center, Department of Internal Medicine, Hospital of Piacenza, Italy. 10. Internal Medicine, Civic Hospital of San Daniele Del Friuli, Italy. 11. Department of Cardiovascular Sciences, Vascular Medicine Unit, University of Padua, Italy.
Abstract
BACKGROUND: The association between venous and arterial thrombotic disorders is still unclear. We assessed the association between residual vein thrombosis (RVT) and subclinical atherosclerosis in a cohort of patients with unprovoked (or associated with weak risk factors) proximal deep-vein thrombosis (DVT). METHODS: In a multicenter cross-sectional study, consecutive patients over 40years free from atherosclerotic disorders received the ultrasound assessment of the leg vein system and that of carotid arteries approximately three months after an episode of proximal DVT. In each center the evaluation was done by two independent assessors. The presence of RVT was defined as the incompressibility of at least 4mm in either the popliteal or the common femoral vein, and that of subclinical atherosclerosis as the presence of increased (>0.9mm) intima-media tickness (IMT) and/or carotid plaques. RESULTS: Out of 252 patients (mean age, 67; males, 53%; unprovoked, 77%), the presence of RVT was found in 139 (55.2%). An increased IMT was shown in 76 (54.7%) patients with and in 35 (31.0%) without RVT (p<0.001). At least one carotid plaque was found in 80 (57.6%) patients with and in 36 (31.9%) without RVT (p<0.001). After adjusting for the baseline characteristics, the odds ratio of subclinical atherosclerosis (increased IMT and/or carotid plaques) was 2.8 (95% CI, 1.6 to 4.7). CONCLUSION: The ultrasound detection of RVT after an episode of proximal DVT that is either unprovoked or triggered by weak risk factors is associated with a higher prevalence of subclinical atherosclerosis. These findings may have implications for patient prognosis.
BACKGROUND: The association between venous and arterial thrombotic disorders is still unclear. We assessed the association between residual vein thrombosis (RVT) and subclinical atherosclerosis in a cohort of patients with unprovoked (or associated with weak risk factors) proximal deep-vein thrombosis (DVT). METHODS: In a multicenter cross-sectional study, consecutive patients over 40years free from atherosclerotic disorders received the ultrasound assessment of the leg vein system and that of carotid arteries approximately three months after an episode of proximal DVT. In each center the evaluation was done by two independent assessors. The presence of RVT was defined as the incompressibility of at least 4mm in either the popliteal or the common femoral vein, and that of subclinical atherosclerosis as the presence of increased (>0.9mm) intima-media tickness (IMT) and/or carotid plaques. RESULTS: Out of 252 patients (mean age, 67; males, 53%; unprovoked, 77%), the presence of RVT was found in 139 (55.2%). An increased IMT was shown in 76 (54.7%) patients with and in 35 (31.0%) without RVT (p<0.001). At least one carotid plaque was found in 80 (57.6%) patients with and in 36 (31.9%) without RVT (p<0.001). After adjusting for the baseline characteristics, the odds ratio of subclinical atherosclerosis (increased IMT and/or carotid plaques) was 2.8 (95% CI, 1.6 to 4.7). CONCLUSION: The ultrasound detection of RVT after an episode of proximal DVT that is either unprovoked or triggered by weak risk factors is associated with a higher prevalence of subclinical atherosclerosis. These findings may have implications for patient prognosis.
Authors: Karsten Keller; Jürgen H Prochaska; Meike Coldewey; Sebastian Göbel; Volker H Schmitt; Omar Hahad; Alexander Ullmann; Markus Nagler; Heidrun Lamparter; Christine Espinola-Klein; Thomas Münzel; Philipp S Wild Journal: Life (Basel) Date: 2022-05-14
Authors: F Dentali; S Barco; S Pegoraro; M N D Di Minno; D Mastroiacovo; F Pomero; C Lodigiani; F Bagna; M Sartori; G Barillari; N Mumoli; M Napolitano; S M Passamonti; R Benedetti; W Ageno; M Di Nisio Journal: J Thromb Thrombolysis Date: 2018-10 Impact factor: 2.300