title: D-dimer, FVIII and thrombotic burden in the acute phase of deep vein thrombosis in relation to the risk of post-thrombotic syndrome.
abstract: BACKGROUND
  Post-thrombotic syndrome (PTS) is the most common complication of deep vein thrombosis (DVT), but few data are available on the risk factors for PTS.
  
  
  OBJECTIVE
  To assess whether the time-course of D-dimer, FVIII, and thrombotic burden are related to PTS development.
  
  
  METHODS
  Patients (n=59) with proximal DVT of the lower limbs (age 64; range:20-88years; male 56%) were enrolled on the day of diagnosis (D0) and all received heparin for 5-7days, overlapped and followed by vitamin K antagonists (VKA) for 3months. Whole-leg compression ultrasound examination was conducted on D0 and 7 (D7), 30 (D30), and 90 (D90) days afterwards, when blood samples were also taken for D-dimer (STA Liatest) and FVIII (chromogenic assay) testing. Thrombotic burden was defined at each time point according to a score, which considered thrombosis extent and occlusion degree. Villalta score was evaluated at D30, D90, and D180.
  
  
  RESULTS
  At D90, 12 patients developed PTS (Villalta score ≥5) and the median Villalta score was 1 (IQR 0.3-3.0) and was not correlated with either D-dimer or FVIIII time course. At D180, 13 patients had PTS and they had similar thrombotic score at D0, D30 to those without PTS, but higher at D90 (7.6±5.1 vs. 3.2±3.6; p=0.011). Thrombotic score at D90 was correlated with Villalta score at D90 (rho=0.374, p=0.009) and at D180 (rho=0.436, p=0.006).
  
  
  CONCLUSIONS
  Thrombotic burden after 90days of VKA is correlated with PTS.
authors: Department of Angiology and Blood Coagulation, S. Orsola-Malpighi University Hospital, 40138 Bologna, Italy.
authors: Michelangelo
authors: M
authors: Sartori
authors: Department of Angiology and Blood Coagulation, S. Orsola-Malpighi University Hospital, 40138 Bologna, Italy.
authors: Elisabetta
authors: E
authors: Favaretto
authors: Department of Angiology and Blood Coagulation, S. Orsola-Malpighi University Hospital, 40138 Bologna, Italy.
authors: Michela
authors: M
authors: Cini
authors: Department of Angiology and Blood Coagulation, S. Orsola-Malpighi University Hospital, 40138 Bologna, Italy.
authors: Cristina
authors: C
authors: Legnani
authors: Department of Angiology and Blood Coagulation, S. Orsola-Malpighi University Hospital, 40138 Bologna, Italy.
authors: Gualtiero
authors: G
authors: Palareti
authors: Department of Angiology and Blood Coagulation, S. Orsola-Malpighi University Hospital, 40138 Bologna, Italy.
authors: Benilde
authors: B
authors: Cosmi
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use; D005169:Factor VIII / Q000032:analysis*; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D007866:Leg / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D054070:Postthrombotic Syndrome / Q000097:blood* / Q000000981:diagnostic imaging / Q000209:etiology*; D012307:Risk Factors; D014463:Ultrasonography; D020246:Venous Thrombosis / Q000097:blood* / Q000150:complications* / Q000000981:diagnostic imaging; D014812:Vitamin K / Q000037:antagonists & inhibitors; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D; D014812:Vitamin K; D005169:Factor VIII; D006493:Heparin
keywords: D-dimer; Deep vein thrombosis; FVIII; Post-thrombotic syndrome; Residual venous obstruction; Thrombotic score