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Long‐term risk of venous thromboembolism recurrence after isolated superficial vein thrombosis
Author(s) -
Galanaud J.P.,
Sevestre M.A.,
Pernod G.,
Kahn S. R.,
Genty C.,
Terrisse H.,
Brisot D.,
Gillet J.L.,
Quéré I.,
Bosson J.L.
Publication year - 2017
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.13679
Subject(s) - medicine , pulmonary embolism , hazard ratio , deep vein , thrombosis , concomitant , surgery , venous thrombosis , incidence (geometry) , confidence interval , retrospective cohort study , prospective cohort study , physics , optics
Essentials Long‐term risk of recurrence of isolated superficial vein thrombosis (SVT) is under‐studied. We analyzed data from a cohort of first SVT and proximal deep vein thrombosis (DVT) without cancer. The risk of recurrence as DVT or pulmonary embolism is twice lower in SVT patients. However, overall risk of recurrence is similar between SVT and proximal DVT patients.Click to hear Dr Decousus’ perspective on superficial vein thrombosisSummary Background Isolated superficial vein thrombosis (i SVT ) (without concomitant deep vein thrombosis [ DVT ] or pulmonary embolism [ PE ]) is a frequent event, but available data on long‐term outcomes are scarce and retrospective. Therefore, we aimed to determine prospectively the risk and type of venous thromboembolism ( VTE ) recurrence after i SVT and compare them with those of proximal DVT. Methods Using data from the prospective, multicenter, observational, OPTIMEV study, we assessed, at 3 years and after anticoagulants were stopped, the incidence and the type of VTE recurrence (i SVT / DVT / PE ) of patients with a first objectively confirmed i SVT without cancer ( n = 285), and compared these with those of patients with a first proximal DVT without cancer ( n = 262). Results As compared with proximal DVT patients, iSVT patients had a similar overall incidence of VTE recurrence (5.4% per patient‐year [PY] versus 6.5% per PY, adjusted hazard ratio [aHR] 0.9, 95% confidence interval [CI] 0.5–1.6), but iSVT recurred six times more often as iSVT (2.7% versus 0.6%, aHR 5.9, 95% CI 1.3–27.1) and 2.5 times less often as deep‐VTE events (2.5% versus 5.9%, aHR 0.4, 95% CI 0.2–0.9). Varicose vein status did not influence the risk or the type of VTE recurrence. Saphenian junction involvement by i SVT was not associated with a higher risk of recurrence (5.2% per PY versus 5.4% per PY ), but was associated with recurrence exclusively as deep‐VTE events. Conclusion In patients with a first i SVT without cancer, after stopping anticoagulants, the incidence of deep‐ VTE recurrence is half that of DVT patients, but the overall risk of recurrence is similar. Ssaphenian junction involvement seems to influence the risk of deep‐ VTE recurrence, whereas varicose vein status has no impact or a low impact on VTE recurrence.