title: Superficial thrombophlebitis and risk for recurrent venous thromboembolism.
abstract: OBJECTIVE
  Superficial thrombophlebitis (ST) is a frequent and potentially serious disease if complicated with venous thromboembolism (VTE). Data on risk factors and incidence rates for ST are scarce. It is also unknown whether ST is a risk factor for recurrence of VTE.
  
  
  METHODS
  After discontinuation of secondary thromboprophylaxis for a first spontaneous VTE, we prospectively observed 615 patients on average for 30 +/- 26 months. Patients with natural coagulation inhibitor deficiency, lupus anticoagulant, or cancer, who were pregnant, or were receiving long-term antithrombotic therapy were excluded. The study outcomes were occurrence of symptomatic ST or objectively documented recurrent symptomatic VTE.
  
  
  RESULTS
  ST developed in 45 patients (7.3%) with a first VTE. High factor VIII concentration emerged as an independent risk factor for ST (relative risk [RR], 2.0; 95% confidence interval [CI], 1.0-5.2), compared with lower levels after adjustment for age and sex; factor V Leiden and prothrombin G20210A concentration; hyperhomocysteinemia; high body mass index; and duration of oral anticoagulation therapy. VTE recurred in 12 (27%) of 45 patients with ST and in 67 (12%) of 570 patients without ST. In patients with VTE, subsequent ST emerged as an independent risk factor for recurrent VTE. Patients with ST had twofold higher RR (2.1; 95% CI, 1.0-4.2) for recurrence than did patients without ST after adjustment for putative confounding variables.
  
  
  CONCLUSIONS
  Patients with a first spontaneous VTE and subsequent ST are at increased risk for recurrent VTE. High factor VIII concentration is an independent risk factor for ST.
authors.affiliation: Department of Internal Medicine I, Division of Hematology and Hemostasis, Vienna University Hospital, Vienna, Austria.
authors.forename: Verena
authors.initials: V
authors.lastname: Schönauer
authors.forename: Paul A
authors.initials: PA
authors.lastname: Kyrle
authors.forename: Ansgar
authors.initials: A
authors.lastname: Weltermann
authors.forename: Erich
authors.initials: E
authors.lastname: Minar
authors.forename: Christine
authors.initials: C
authors.lastname: Bialonczyk
authors.forename: Mirko
authors.initials: M
authors.lastname: Hirschl
authors.forename: Peter
authors.initials: P
authors.lastname: Quehenberger
authors.forename: Barbara
authors.initials: B
authors.lastname: Schneider
authors.forename: Hugo
authors.initials: H
authors.lastname: Partsch
authors.forename: Sabine
authors.initials: S
authors.lastname: Eichinger
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005169:Factor VIII / Q000032:analysis; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D019370:Observation; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000209:etiology*; D012008:Recurrence; D012307:Risk Factors; D013923:Thromboembolism / Q000150:complications* / Q000453:epidemiology; D013924:Thrombophlebitis / Q000097:blood / Q000150:complications* / Q000453:epidemiology
chemical_list: D005169:Factor VIII