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Association between thrombophilia and the post‐thrombotic syndrome: a systematic review and meta‐analysis
Author(s) -
Rabinovich A.,
Cohen J. M.,
Prandoni P.,
Kahn S. R.
Publication year - 2014
Publication title -
journal of thrombosis and haemostasis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.947
H-Index - 178
eISSN - 1538-7836
pISSN - 1538-7933
DOI - 10.1111/jth.12447
Subject(s) - medicine , thrombophilia , odds ratio , meta analysis , factor v leiden , prothrombin g20210a , post thrombotic syndrome , thrombosis , venous thrombosis , antiphospholipid syndrome
Summary Background The postthrombotic syndrome ( PTS ) is a frequent chronic complication of deep vein thrombosis ( DVT ), occurring in 20–40% of patients. Identifying risk factors for PTS may be useful to provide patients with prognostic information and target prevention strategies. Objective To conduct a systematic review to assess whether, among patients with DVT , inherited and acquired thrombophilias are associated with a risk of PTS . Methods We searched the electronic databases P ub M ed, EMBASE , S copus, and W eb of S cience for studies published from 1990 to 2013 that assessed any thrombophilia in adult DVT patients and its association with the development of PTS . We calculated odds ratios and 95% confidence intervals for PTS according to the presence of thrombophilia. Meta‐analysis was performed using the random‐effects model. Results Sixteen studies were included: 13 assessed f actor V L eiden ( FVL ), 10 assessed prothrombin mutation, five assessed protein S and C deficiencies, three assessed antithrombin deficiency, four assessed elevated FVIII levels, and six assessed antiphospholipid antibodies. None of the meta‐analyses identified any thrombophilia to be predictive of PTS . Both FVL and prothrombin mutation appeared protective among studies including patients with both first and recurrent DVT and studies in which more than 50% of patients had an unprovoked DVT . Conclusions Our meta‐analysis did not demonstrate a significant association between any of the thrombophilias assessed and the risk of PTS in DVT patients. Other biomarkers in the pathophysiological pathway may be more predictive of PTS .