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New and known predictors of the postthrombotic syndrome: A subanalysis of the ATTRACT trial

INTRODUCTION: Postthrombotic syndrome (PTS) remains associated with significant clinical and economic burden. This study aimed to investigate known and novel predictors of the development of PTS in participants of the ATTRACT (Acute Venous Thrombosis: Thrombus Removal With Adjunctive Catheter‐Direct...

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Autores principales: Rinfret, Félix, Gu, Chu‐Shu, Vedantham, Suresh, Kahn, Susan R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9424505/
https://www.ncbi.nlm.nih.gov/pubmed/36051541
http://dx.doi.org/10.1002/rth2.12796
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author Rinfret, Félix
Gu, Chu‐Shu
Vedantham, Suresh
Kahn, Susan R.
author_facet Rinfret, Félix
Gu, Chu‐Shu
Vedantham, Suresh
Kahn, Susan R.
author_sort Rinfret, Félix
collection PubMed
description INTRODUCTION: Postthrombotic syndrome (PTS) remains associated with significant clinical and economic burden. This study aimed to investigate known and novel predictors of the development of PTS in participants of the ATTRACT (Acute Venous Thrombosis: Thrombus Removal With Adjunctive Catheter‐Directed Thrombolysis) trial. METHODS: We used multivariable logistic regression to identify baseline and postbaseline factors that were predictive of the development of PTS during study follow‐up, as defined by a Villalta score of 5 or greater or the development of a venous ulcer from 6 to 24 months after enrollment. RESULTS: Among 691 patients in the study cohort (all had proximal deep vein thrombosis [DVT] that extended above the popliteal vein, of which 57% had iliofemoral DVT), 47% developed PTS. Further, we identified that Villalta score at baseline (odds ratio [OR], 1.09 [95% confidence interval [CI], 1.05–1.13] per one‐unit increase) and employment status (unemployed due to disability: OR, 3.31 [95% CI, 1.72–6.35] vs. employed more than 35 hours per week) were predictive of PTS. In terms of postbaseline predictors, leg pain severity at day 10 (OR, 1.28 [95% CI, 1.13–1.45] per 1‐point increase in a 7‐point scale) predicted PTS. Also, patients receiving rivaroxaban on day 10 following randomization had lower rates of PTS (OR, 0.53 [95% CI, 0.33–0.86]) than patients on warfarin. CONCLUSIONS: Novel predictors for PTS identified in our study include baseline Villalta score, leg pain severity at 10 days, and unemployed due to disability. Our findings also suggest that the initial choice of anticoagulant to treat DVT may have an impact on the development of PTS.
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spelling pubmed-94245052022-08-31 New and known predictors of the postthrombotic syndrome: A subanalysis of the ATTRACT trial Rinfret, Félix Gu, Chu‐Shu Vedantham, Suresh Kahn, Susan R. Res Pract Thromb Haemost Original Articles INTRODUCTION: Postthrombotic syndrome (PTS) remains associated with significant clinical and economic burden. This study aimed to investigate known and novel predictors of the development of PTS in participants of the ATTRACT (Acute Venous Thrombosis: Thrombus Removal With Adjunctive Catheter‐Directed Thrombolysis) trial. METHODS: We used multivariable logistic regression to identify baseline and postbaseline factors that were predictive of the development of PTS during study follow‐up, as defined by a Villalta score of 5 or greater or the development of a venous ulcer from 6 to 24 months after enrollment. RESULTS: Among 691 patients in the study cohort (all had proximal deep vein thrombosis [DVT] that extended above the popliteal vein, of which 57% had iliofemoral DVT), 47% developed PTS. Further, we identified that Villalta score at baseline (odds ratio [OR], 1.09 [95% confidence interval [CI], 1.05–1.13] per one‐unit increase) and employment status (unemployed due to disability: OR, 3.31 [95% CI, 1.72–6.35] vs. employed more than 35 hours per week) were predictive of PTS. In terms of postbaseline predictors, leg pain severity at day 10 (OR, 1.28 [95% CI, 1.13–1.45] per 1‐point increase in a 7‐point scale) predicted PTS. Also, patients receiving rivaroxaban on day 10 following randomization had lower rates of PTS (OR, 0.53 [95% CI, 0.33–0.86]) than patients on warfarin. CONCLUSIONS: Novel predictors for PTS identified in our study include baseline Villalta score, leg pain severity at 10 days, and unemployed due to disability. Our findings also suggest that the initial choice of anticoagulant to treat DVT may have an impact on the development of PTS. John Wiley and Sons Inc. 2022-08-29 /pmc/articles/PMC9424505/ /pubmed/36051541 http://dx.doi.org/10.1002/rth2.12796 Text en © 2022 The Authors. Research and Practice in Thrombosis and Haemostasis published by Wiley Periodicals LLC on behalf of International Society on Thrombosis and Haemostasis (ISTH). https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Rinfret, Félix
Gu, Chu‐Shu
Vedantham, Suresh
Kahn, Susan R.
New and known predictors of the postthrombotic syndrome: A subanalysis of the ATTRACT trial
title New and known predictors of the postthrombotic syndrome: A subanalysis of the ATTRACT trial
title_full New and known predictors of the postthrombotic syndrome: A subanalysis of the ATTRACT trial
title_fullStr New and known predictors of the postthrombotic syndrome: A subanalysis of the ATTRACT trial
title_full_unstemmed New and known predictors of the postthrombotic syndrome: A subanalysis of the ATTRACT trial
title_short New and known predictors of the postthrombotic syndrome: A subanalysis of the ATTRACT trial
title_sort new and known predictors of the postthrombotic syndrome: a subanalysis of the attract trial
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9424505/
https://www.ncbi.nlm.nih.gov/pubmed/36051541
http://dx.doi.org/10.1002/rth2.12796
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