title: The role of inflammation in post-thrombotic syndrome after pregnancy-related deep vein thrombosis: A population-based, cross-sectional study.
abstract: Previous studies suggest that inflammation may play a role in the pathophysiology of post-thrombotic syndrome (PTS). The aims of the present study were to evaluate markers of inflammation as possible predictors for PTS after pregnancy-related deep vein thrombosis (DVT). We included 182 women with a pregnancy-related DVT during 1990-2003 and 314 controls. All women answered a questionnaire and donated a blood sample in 2006. PTS was diagnosed when a self-reported Villalta score was above 4. The following predictors of PTS were included: high sensitivity C-reactive protein (hsCRP), interleukin (IL)-6, IL-8, IL-10, monocyte chemotactic protein (MCP)-1, transforming growth factor (TGF)-β1, platelet derived growth factor (PDGF)-BB, and the two adhesion molecules intercellular adhesion molecule (ICAM)-1 and vascular cell adhesion molecule (VCAM)-1. High values were defined as above median value among controls. We found that 41% of cases were diagnosed with PTS 3-16years after index pregnancy. In univariate analyses, high values of hsCRP, IL-6, and IL-10 were significantly associated with PTS with ORs 2.3 (95% CI; 1.2-4.2, p=0.008), 1.9 (1.0-3.5, p=0.04), and 10.8 (1.3-89.8, p=0.01), respectively. Only hsCRP, which has previously been found to be independently associated with PTS, was independently associated with PTS in a multivariate logistic regression model, when adjusting for proximal DVT occurring postpartum, age above 33years, and smoking (adjusted OR 2.4; 95% CI 1.2-4.8, p=0.01). We conclude that hsCRP was associated with PTS 3-16years after pregnancy-related DVT.
authors.affiliation: Oslo University Hospital, Department of Haematology, Oslo, Norway. Electronic address: hilde.skuterud.wik@rr-research.no.
authors.forename: Hilde Skuterud
authors.initials: HS
authors.lastname: Wik
authors.affiliation: Oslo University Hospital, Department of Obstetrics and Gynaecology, Oslo, Norway; University of Oslo, Institute of Clinical Medicine, Oslo, Norway. Electronic address: UXAFJA@ous-hf.no.
authors.forename: Anne Flem
authors.initials: AF
authors.lastname: Jacobsen
authors.affiliation: Oslo University Hospital, Department of Haematology, Oslo, Norway; Oslo University Hospital, Research Institute of Internal Medicine, Oslo, Norway. Electronic address: UXMAOW@ous-hf.no.
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Mowinckel
authors.affiliation: Oslo University Hospital, Department of Haematology, Oslo, Norway; University of Oslo, Institute of Clinical Medicine, Oslo, Norway; Oslo University Hospital, Research Institute of Internal Medicine, Oslo, Norway. Electronic address: p.m.sandset@medisin.uio.no.
authors.forename: Per Morten
authors.initials: PM
authors.lastname: Sandset
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000276:immunology; D018932:Chemokine CCL2 / Q000097:blood / Q000276:immunology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000150:complications* / Q000276:immunology; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood / Q000276:immunology; D007378:Interleukins / Q000097:blood / Q000276:immunology; D054070:Postthrombotic Syndrome / Q000097:blood / Q000150:complications* / Q000276:immunology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000097:blood / Q000276:immunology*; D016212:Transforming Growth Factor beta / Q000097:blood / Q000276:immunology; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood / Q000276:immunology; D020246:Venous Thrombosis / Q000097:blood / Q000150:complications* / Q000276:immunology
chemical_list: D015415:Biomarkers; D018932:Chemokine CCL2; D007378:Interleukins; D016212:Transforming Growth Factor beta; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1; D002097:C-Reactive Protein
keywords: Inflammation; Post-thrombotic syndrome; Postpartum period; Pregnancy; Venous thrombosis