動脈硬化の怖さは、ここにもある。
表在性静脈血栓症、静脈性血栓塞栓症の合併高率

表在性静脈血栓症、静脈性血栓塞栓症の合併高率

文献：Decousus H et al. Superficial Venous Thrombosis and Venous Thromboembolism: A Large, Prospective Epidemiologic Study. Ann Intern Med. 2010;152(4):218-24

表在性静脈血栓症患者844名を対象に、静脈性血栓塞栓症の罹患率・リスクを前向きコホート研究で調査。登録時に210名（24.9％）の患者が静脈性血栓塞栓症を合併しており、合併がない患者でも、3カ月間の追跡期間中に600名中58名（10.2％）で血栓塞栓症の合併が見られた。

Superficial Venous Thrombosis and Venous Thromboembolism

A Large, Prospective Epidemiologic Study

  1. Herve Decousus, MD;
  2. Isabelle Quere, MD;
  3. Emilie Presles, MD;
  4. Francois Becker, MD;
  5. Marie-Therese Barrellier, MD;
  6. Myriam Chanut, MD;
  7. Jean-Luc Gillet, MD;
  8. Herve Guenneguez, MD;
  9. Christine Leandri, MD;
  10. Patrick Mismetti, MD, PhD;
  11. Olivier Pichot, MD;
  12. Alain Leizorovicz, MD; and
  13. for the POST (Prospective Observational Superficial Thrombophlebitis) Study Group*

+ Author Affiliations

  1. From University Hospital, Saint-Etienne, France; Saint Eloi University Hospital, Montpellier, France; University Hospital, Geneva, Switzerland; University Hospital, Caen, France; Vascular Medicine, Aubenas, France; Vascular Medicine, Bourgoin-Jailleu, France; Megival Clinic, Saint-Aubin-sur-Scie, France; Vascular Medicine, Annonay, France; Vascular Medicine, Grenoble, France; and UMR 5558, Lyon, France.

Abstract

Background: Superficial venous thrombosis (SVT) is perceived to have a benign prognosis.

Objective: To assess the prevalence of venous thromboembolism in patients with SVT and to determine the 3-month incidence of thromboembolic complications.

Design: National cross-sectional and prospective epidemiologic cohort study. (ClinicalTrials.gov registration number: NCT00818688)

Setting: French office- and hospital-based vascular medicine specialists.

Patients: 844 consecutive patients with symptomatic SVT of the lower limbs that was at least 5 cm on compression ultrasonography.

Measurements: Incidence of venous thromboembolism and extension or recurrence of SVT in patients with isolated SVT at presentation.

Results: Among 844 patients with SVT at inclusion (median age, 65 years; 547 women), 210 (24.9%) also had deep venous thrombosis (DVT) or symptomatic pulmonary embolism. Among 600 patients without DVT or pulmonary embolism at inclusion who were eligible for 3-month follow-up, 58 (10.2%) developed thromboembolic complications at 3 months (pulmonary embolism, 3 [0.5%]; DVT, 15 [2.8%]; extension of SVT, 18 [3.3%]; and recurrence of SVT, 10 [1.9%]), despite 540 patients (90.5%) having received anticoagulants. Risk factors for complications at 3 months were male sex, history of DVT or pulmonary embolism, previous cancer, and absence of varicose veins.

Limitation: The findings are from a specialist referral setting, and the study was terminated before the target patient population was reached because of slow recruitment.

Conclusion: A substantial number of patients with SVT exhibit venous thromboembolism at presentation, and some that do not can develop this complication in the subsequent 3 months.

Primary Funding Source: GlaxoSmithKline, sanofi-aventis, and the Ministere Francais de la Sante et des Sports (Programme Hospitalier de Recherche Clinique).

Article and Author Information

  • Note: This work was presented as 2 abstracts at the Congress of the International Society of Thrombosis and Haemostasis, Geneva, Switzerland, 6-12 July 2007 (J Thromb Haemost. 2007;5 (supp 1):abstracts O-S-OR9 and P-S 600).

  • Acknowledgment: The authors thank Zohra Akkal for her assistance in coordinating the study.

  • Grant Support: By GlaxoSmithKline, sanofi-aventis, the Ministere Francais de la Sante et des Sports (Programme Hospitalier de Recherche Clinique), the Societe Francaise de Medecine Vasculaire, and the Societe Francaise de Phlebologie.

  • Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M09-0686.

  • Reproducible Research Statement: Study protocol, statistical code, and data set: Available from Dr. Decousus (e-mail, herve.decousus@chu-st-etienne.fr)

  • Requests for Single Reprints: Herve Decousus, MD, Service de Medecine et Therapeutique, Groupe de recherche sur la thrombose (EA 3065), Centre d'Investigation Clinique CIE3 (INSERM/DHOS), Hopital Nord, CHU Saint-Etienne, 42055 Saint-Etienne Cedex, France.

  • Current Author Addresses: Dr. Decousus: Service de Medecine et Therapeutique, Hopital Nord, Batiment A, Niveau 0, 42055 Saint-Etienne Cedex 2, France.

  • Dr. Quere: CHU de Montpellier, Service des Maladies Vasculaires, Hopital Saint-Eloi, 80 rue Fliche, 34295 Montpellier Cedex 5, France.

  • Dr. Presles: CHU de Saint-Etienne, Batiment Recherche, Hopital Nord, 42055 Saint-Etienne Cedex 2, France.

  • Dr. Becker: 40 chemin Favrands, 74400 Chamonix, France.

  • Dr. Barrellier: Laboratoire des Explorations Fonctionnelles, Niveau 01, CHU Cote de Nacre, 14033 Caen Cedex, France.

  • Dr. Chanut: Medecine Vasculaire, Le Clos de Bellande, Rue Denis Papin, 07200 Aubenas, France.

  • Dr. Gillet: Medecine Vasculaire, 51 Bis avenue Professeur Tixier, 38300 Bourgoin-Jaillieu, France.

  • Dr. Guenneguez: Clinique Megival, 1328 avenue Maison Blanche, 76550 Saint-Aubin-sur-Scie, France.

  • Dr. Leandri: Medecine Vasculaire, Les Domaines de la Gare, 07100 Annonay, France.

  • Dr. Mismetti: URCIP, Batiment Recherche, Hopital Nord, 2055 Saint-Etienne Cedex 2, France.

  • Dr. Pichot: Centre de Medecine Vasculaire, 7 rue Lesdiguieres, 38000 Grenoble, France.

  • Dr. Leizorovicz: Service de Pharmacologie Clinique, Faculte Laennec, rue Guillaume Paradin, BP 8071, 69376 Lyon Cedex 8, France.

  • Author Contributions: Conception and design: H. Decousus, I. Quere, F. Becker, J.L. Gillet, P. Mismetti, O. Pichot.

  • Analysis and interpretation of the data: H. Decousus, I. Quere, F. Becker, P. Mismetti, A. Leizorovicz.

  • Drafting of the article: H. Decousus, P. Mismetti, A. Leizorovicz.

  • Critical revision of the article for important intellectual content: H. Decousus, I. Quere, F. Becker, J.L. Gillet, P. Mismetti, O. Pichot, A. Leizorovicz.

  • Final approval of the article: H. Decousus, I. Quere, F. Becker, M.T. Barrellier, M. Chanut, H. Guenneguez, C. Leandri, P. Mismetti, O. Pichot, A. Leizorovicz.

  • Provision of study materials or patients: I. Quere, M. Chanut, J.L. Gillet, H. Guenneguez, C. Leandri, O. Pichot.

  • Statistical expertise: E. Presles.

  • Obtaining of funding: A. Leizorovicz.

  • Administrative, technical, or logistic support: H. Decousus, I. Quere, E. Presles, M.T. Barrellier, A. Leizorovicz.

  • Collection and assembly of data: A. Leizorovicz.

  • * For a list of participating committees and investigators, see the Appendix.

2010.2.18　記事提供：Ann Intern Med