JAMA Cardiol:孤立性远端深静脉栓塞预后明显优于近端深静脉栓塞

2022-08-11 MedSci原创 MedSci原创

与近端深静脉栓塞患者相比,孤立性远端深静脉栓塞患者的预后相对较好

目前,关于孤立性远端深静脉栓塞 (IDDVT) 即腘下静脉血栓形成而无近端延伸或肺栓塞 (PE) 的患者的临床表现、短期和长期预后的资料仍不足。

该研究旨在确定IDDVT患者的临床特征、短期和1年预后,并与近端DVT患者进行比较。

这是一项多中心的国际性队列研究,纳入了于2001年3月1日-2021年2月28日期间注册的IDDVT患者。同时纳入近端DVT患者以进行对比。排除既往有过无症状DVT、上肢DVT、并存PE或COVID-19感染病史的患者。主要终点是90天和1年死亡率、1年大出血和1年静脉栓塞(VTE)加重。


远端DVT和近端DVT患者的全因死亡率

共纳入了33897位孤立性DVT患者(无并存PE),其中5938位(17.5%)为IDDVT(平均61岁,2975位男性[50.1%]),27959位(82.5%)为近端DVT(平均65岁,14315位男性[51.2%])。与近端DVT患者相比,IDDVT患者的共病负担较低,但近期手术或接受激素治疗的可能性更大。与近端DVT患者相比,IDDVT患者的90天死亡风险较低(优势比[OR] 0.47)。无论有无进行校正,1年死亡率与90天死亡率结果相近(HR 0.52[未校正],HR 0.72[校正后])。

IDDVT患者静脉血栓栓塞恶化的1年风险较低(HR 0.83)。在前三个月无不良事件的患者的1年校正分析中,IDDVT与更低的VTE恶化风险相关(校正HR 0.48)。经过1年随访后,IDDVT患者更少见血栓后综合征的症状或体征(47.6% vs 60.5%)。

综上,该队列研究提示,与近端DVT患者相比,IDDVT患者的预后相对较好。这些差异可能是由多因素造成的,包括人口统计、危险因素、合并症 (尤其是全因死亡率) 的差异,以及血栓位置与VTE恶化和血栓后综合征的潜在关联。

 

原始出处:

Bikdeli B, Caraballo C, Trujillo-Santos J, et al. Clinical Presentation and Short- and Long-term Outcomes in Patients With Isolated Distal Deep Vein Thrombosis vs Proximal Deep Vein Thrombosis in the RIETE Registry. JAMA Cardiol. Published online July 13, 2022. doi:10.1001/jamacardio.2022.1988

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    2022-10-29 fusion
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    2022-08-13 jxrzshh
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    2022-08-13 hittouch
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    2022-08-11 ms6219622517209149

    👍👍👍

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  6. [GetPortalCommentsPageByObjectIdResponse(id=1782173, encodeId=fae11e82173f2, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7532500500, createdName=12499e01m47暂无昵称, createdTime=Sun Jun 25 08:09:37 CST 2023, time=2023-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1698415, encodeId=f279169841548, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Sat Oct 29 16:09:37 CST 2022, time=2022-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1525665, encodeId=594b15256651c, content=<a href='/topic/show?id=2ef14545092' target=_blank style='color:#2F92EE;'>#孤立性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45450, encryptionId=2ef14545092, topicName=孤立性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cdb511649913, createdName=jxrzshh, createdTime=Sat Aug 13 06:09:37 CST 2022, time=2022-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1579527, encodeId=ab6e15e9527ba, content=<a href='/topic/show?id=3afd942e905' target=_blank style='color:#2F92EE;'>#近端#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94279, encryptionId=3afd942e905, topicName=近端)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=da2116536440, createdName=hittouch, createdTime=Sat Aug 13 06:09:37 CST 2022, time=2022-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1238148, encodeId=8f8a12381487d, content=👍👍👍, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a851782691, createdName=ms6219622517209149, createdTime=Thu Aug 11 22:17:30 CST 2022, time=2022-08-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1243648, encodeId=0732124364829, content=JAMA上文章都是顶级的,谢谢梅斯及时上新, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=肿瘤克星, createdTime=Thu Aug 11 18:09:37 CST 2022, time=2022-08-11, status=1, ipAttribution=)]
    2022-08-11 肿瘤克星

    JAMA上文章都是顶级的,谢谢梅斯及时上新

    0

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