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Heart failure in patients with deep vein thrombosis.

Abstract

Patients with heart failure (HF) are particularly vulnerable to the development of venous thromboembolism (VTE) and its related complications of pulmonary embolism and right ventricular failure. To improve our understanding of the clinical characteristics, prophylaxis, and initial management of patients with HF and deep vein thrombosis (DVT), we compared 685 patients with a history of HF with 3,890 patients without HF in a prospective registry of 5,451 consecutive patients with ultrasound-confirmed DVT. We excluded 876 patients for whom data regarding HF status were incomplete. Patients with HF had an increased frequency of co-morbid conditions such as neurologic disease including stroke (33% vs 26%, p = 0.0002), acute lung disease including pneumonia (31% vs 15%, p <0.0001), and acute coronary syndrome (11% vs 4%, p <0.0001) contributing to a higher medical acuity than in patients without HF. Furthermore, patients with HF were more likely to have VTE risk factors of immobilization (53% vs 42%, p <0.0001), acute infection (33% vs 27%, p = 0.01), and chronic obstructive pulmonary disease (29% vs 12%, p <0.0001). Patients with and without HF and DVT had a high frequency of recent hospitalization (48% vs 47%, p = 0.96). Fewer than 12 of patients with HF (46%) who subsequently developed DVT received any VTE prophylaxis. In conclusion, the combination of higher medical acuity, increased frequency of VTE risk factors, and low rate of VTE prophylaxis presents a "triple threat" to patients with HF.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. gpiazza@bidmc.harvard.edu <gpiazza@bidmc.harvard.edu>

    ,

    Source

    The American journal of cardiology 101:7 2008 Apr 01 pg 1056-9

    MeSH

    Aged
    Aged, 80 and over
    Female
    Heart Failure
    Humans
    Male
    Registries
    Risk Factors
    Ultrasonography
    Venous Thrombosis

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    18359331

    Citation

    Piazza, Gregory, et al. "Heart Failure in Patients With Deep Vein Thrombosis." The American Journal of Cardiology, vol. 101, no. 7, 2008, pp. 1056-9.
    Piazza G, Seddighzadeh A, Goldhaber SZ. Heart failure in patients with deep vein thrombosis. Am J Cardiol. 2008;101(7):1056-9.
    Piazza, G., Seddighzadeh, A., & Goldhaber, S. Z. (2008). Heart failure in patients with deep vein thrombosis. The American Journal of Cardiology, 101(7), pp. 1056-9. doi:10.1016/j.amjcard.2007.11.051.
    Piazza G, Seddighzadeh A, Goldhaber SZ. Heart Failure in Patients With Deep Vein Thrombosis. Am J Cardiol. 2008 Apr 1;101(7):1056-9. PubMed PMID: 18359331.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Heart failure in patients with deep vein thrombosis. AU - Piazza,Gregory, AU - Seddighzadeh,Ali, AU - Goldhaber,Samuel Z, Y1 - 2008/01/28/ PY - 2007/10/16/received PY - 2007/11/21/revised PY - 2007/11/21/accepted PY - 2008/3/25/pubmed PY - 2008/5/16/medline PY - 2008/3/25/entrez SP - 1056 EP - 9 JF - The American journal of cardiology JO - Am. J. Cardiol. VL - 101 IS - 7 N2 - Patients with heart failure (HF) are particularly vulnerable to the development of venous thromboembolism (VTE) and its related complications of pulmonary embolism and right ventricular failure. To improve our understanding of the clinical characteristics, prophylaxis, and initial management of patients with HF and deep vein thrombosis (DVT), we compared 685 patients with a history of HF with 3,890 patients without HF in a prospective registry of 5,451 consecutive patients with ultrasound-confirmed DVT. We excluded 876 patients for whom data regarding HF status were incomplete. Patients with HF had an increased frequency of co-morbid conditions such as neurologic disease including stroke (33% vs 26%, p = 0.0002), acute lung disease including pneumonia (31% vs 15%, p <0.0001), and acute coronary syndrome (11% vs 4%, p <0.0001) contributing to a higher medical acuity than in patients without HF. Furthermore, patients with HF were more likely to have VTE risk factors of immobilization (53% vs 42%, p <0.0001), acute infection (33% vs 27%, p = 0.01), and chronic obstructive pulmonary disease (29% vs 12%, p <0.0001). Patients with and without HF and DVT had a high frequency of recent hospitalization (48% vs 47%, p = 0.96). Fewer than 12 of patients with HF (46%) who subsequently developed DVT received any VTE prophylaxis. In conclusion, the combination of higher medical acuity, increased frequency of VTE risk factors, and low rate of VTE prophylaxis presents a "triple threat" to patients with HF. SN - 0002-9149 UR - https://www.unboundmedicine.com/medline/citation/18359331/Heart_failure_in_patients_with_deep_vein_thrombosis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(07)02372-7 DB - PRIME DP - Unbound Medicine ER -