Tags

Type your tag names separated by a space and hit enter

Risk factors and recurrence rate of primary deep vein thrombosis of the upper extremities.
Circulation. 2004 Aug 03; 110(5):566-70.Circ

Abstract

BACKGROUND

One third of cases of upper-extremity deep vein thrombosis (DVT) are primary, ie, they occur in the absence of central venous catheters or cancer. Risk factors for primary upper-extremity DVT are not well established, and the recurrence rate is unknown.

METHODS AND RESULTS

We studied 115 primary upper-extremity DVT patients and 797 healthy controls for the presence of thrombophilia due to factor V Leiden, prothrombin G20210A, antithrombin, protein C, protein S deficiency, and hyperhomocysteinemia. Transient risk factors for venous thromboembolism were recorded. Recurrent upper-extremity DVT was evaluated prospectively over a median of 5.1 years of follow-up. The adjusted odds ratio for upper-extremity DVT was 6.2 (95% CI 2.5 to 15.7) for factor V Leiden, 5.0 (95% CI 2.0 to 12.2) for prothrombin G20210A, and 4.9 (95% CI 1.1 to 22.0) for the anticoagulant protein deficiencies. Hyperhomocysteinemia and oral contraceptives were not associated with upper-extremity DVT. However, in women with factor V Leiden or prothrombin G20210A who were taking oral contraceptives, the odds ratio for upper-extremity DVT was increased up to 13.6 (95% CI 2.7 to 67.3). The recurrence rate was 4.4% patient-years in patients with thrombophilia and 1.6% patient-years in those without thrombophilia. The hazard ratio for recurrent upper-extremity DVT in patients with thrombophilia compared with those without was 2.7 (95% CI 0.7 to 9.8).

CONCLUSIONS

Inherited thrombophilia is associated with an increased risk of upper-extremity DVT. Oral contraceptives increase the risk only when combined with inherited thrombophilia. The recurrence rate of primary upper-extremity DVT is low but tends to be higher in patients with thrombophilia than in those without.

Authors+Show Affiliations

Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Department of Internal Medicine and Dermatology, Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Maggiore Policlinico, University of Milano, Italy. martin@policlinico.mi.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15262837

Citation

Martinelli, Ida, et al. "Risk Factors and Recurrence Rate of Primary Deep Vein Thrombosis of the Upper Extremities." Circulation, vol. 110, no. 5, 2004, pp. 566-70.
Martinelli I, Battaglioli T, Bucciarelli P, et al. Risk factors and recurrence rate of primary deep vein thrombosis of the upper extremities. Circulation. 2004;110(5):566-70.
Martinelli, I., Battaglioli, T., Bucciarelli, P., Passamonti, S. M., & Mannucci, P. M. (2004). Risk factors and recurrence rate of primary deep vein thrombosis of the upper extremities. Circulation, 110(5), 566-70.
Martinelli I, et al. Risk Factors and Recurrence Rate of Primary Deep Vein Thrombosis of the Upper Extremities. Circulation. 2004 Aug 3;110(5):566-70. PubMed PMID: 15262837.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk factors and recurrence rate of primary deep vein thrombosis of the upper extremities. AU - Martinelli,Ida, AU - Battaglioli,Tullia, AU - Bucciarelli,Paolo, AU - Passamonti,Serena Maria, AU - Mannucci,Pier Mannuccio, Y1 - 2004/07/19/ PY - 2004/7/21/pubmed PY - 2005/2/5/medline PY - 2004/7/21/entrez SP - 566 EP - 70 JF - Circulation JO - Circulation VL - 110 IS - 5 N2 - BACKGROUND: One third of cases of upper-extremity deep vein thrombosis (DVT) are primary, ie, they occur in the absence of central venous catheters or cancer. Risk factors for primary upper-extremity DVT are not well established, and the recurrence rate is unknown. METHODS AND RESULTS: We studied 115 primary upper-extremity DVT patients and 797 healthy controls for the presence of thrombophilia due to factor V Leiden, prothrombin G20210A, antithrombin, protein C, protein S deficiency, and hyperhomocysteinemia. Transient risk factors for venous thromboembolism were recorded. Recurrent upper-extremity DVT was evaluated prospectively over a median of 5.1 years of follow-up. The adjusted odds ratio for upper-extremity DVT was 6.2 (95% CI 2.5 to 15.7) for factor V Leiden, 5.0 (95% CI 2.0 to 12.2) for prothrombin G20210A, and 4.9 (95% CI 1.1 to 22.0) for the anticoagulant protein deficiencies. Hyperhomocysteinemia and oral contraceptives were not associated with upper-extremity DVT. However, in women with factor V Leiden or prothrombin G20210A who were taking oral contraceptives, the odds ratio for upper-extremity DVT was increased up to 13.6 (95% CI 2.7 to 67.3). The recurrence rate was 4.4% patient-years in patients with thrombophilia and 1.6% patient-years in those without thrombophilia. The hazard ratio for recurrent upper-extremity DVT in patients with thrombophilia compared with those without was 2.7 (95% CI 0.7 to 9.8). CONCLUSIONS: Inherited thrombophilia is associated with an increased risk of upper-extremity DVT. Oral contraceptives increase the risk only when combined with inherited thrombophilia. The recurrence rate of primary upper-extremity DVT is low but tends to be higher in patients with thrombophilia than in those without. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/15262837/Risk_factors_and_recurrence_rate_of_primary_deep_vein_thrombosis_of_the_upper_extremities_ L2 - https://www.ahajournals.org/doi/10.1161/01.CIR.0000137123.55051.9B?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -