Abstract 10924: Mortality and Cardiovascular Events in Patients With Arm Thrombosis. A 3-Year Follow up Registry.
Upper extremity deep venous thrombosis (UE-DVT) is relatively unknown and uncommon and may be a sign of hidden pathology. A recent study has indicated that the incidence of recurrent thrombosis and 3-year mortality are higher in subjects with UE-DVT (Flinterman LE et al. Circulation 2008;118:1366). The consequences of UE-DVT are not well known. According to Flinterman's protocol we studied the incidence of UE-DVT, the survival of patients at 3 years, cardiovascular events and the related risk factors associated to recurrence in an open registry study.
Methods: 211 patients with UE-DVT (age ange 23–70 years) were evaluated for at least 3 years. Ultrasound scans were used to evaluate the presence of thrombosis and for follow up evaluations (every 6 months, excluding new episodes requiring scans).
Results. With UE-DVT, survival was reduced (26.4% of our patients died versus 24.55% in Flinterman's study). This observation was 5.43 times higher than age-sex-adjusted population rates. In 36.2% of patients a neoplastic condition was diagnosed within the follow up period. The risk of non-fatal, cardiovascular events (strokes, myocardial infarction, embolisation, DVT, pulmonary embolism) was 3.22 times higher in UE-DVT patients than in the normal, comparable population. The risk of UE-DVT recurrence was 2.5 times higher in women. During the follow up, 7 new UE-DVT (3.31% versus 13% in Flinterman's report) were diagnosed as recurrent thromboses. The incidence rate was 36.22 (versus 43.2 in the Flinterman report) per 1000 person-years. Anticoagulant treatment and arm exercise abolished recurrence, without altering survival and reduced the global occurrence of cardiovascular events. No pulmonary embolisation was observed. A BMI >26 kg/m2 increased the risk of cardiovascular events (2.33 times) and thrombosis recurrence (2.47 times). Prothrombotic conditions and genetic factors associated to thrombosis did not increase the risk of recurrence, mortality or events.
Conclusion. Subjects with an episode of UE-DVT appear to have a reduced survival and increased risk of cardiovascular events. The rate of recurrence was higher in subjects with BMI >26 kg/m2 and in women. UE-DVT is ofter the first sign of a tumor.
- © 2010 by American Heart Association, Inc.