Skip to main content
Top

20-03-2024 | Chronic Heart Failure | Original Article

Incidence and characteristic of deep venous thrombosis in hospitalized chronic heart failure patients

Authors: Jia-Lin Yuan, Wen Kang Xiao, Chao Qiong Zhang, Le Sun, Ying Kang Lin, Chuang-Xiong Hong

Published in: Heart and Vessels

Login to get access

Abstract

Background

This study was conducted to investigate the incidence of deep venous thrombosis (DVT), outcomes and its characteristics in patients with chronic heart failure (CHF) in a retrospective setting.

Outcomes

Patients died of cardiac shock or acute exacerbation of heart failure (HF), admitted to intensive care unit (ICU) due to acute exacerbation of HF, patients decided to withdraw treatment and return home due to acute exacerbation of HF.

Methods

From January 2015 to June 2022, we admitted 359 patients diagnosed with CHF, and lower limb ultrasonography was performed for the examination of DVT after admission. The incidence of DVT was recorded and patients with known risk factors of VTE were identified and excluded after incidence of DVT was calculated. Patients’ clinical data were then collected.

Results

The occurrence of DVT was 10.0% (36/359), as calf intramuscular vein thrombosis was the main constitution (n  =  28, 75%). DVT patients with other factors (carcinoma, surgery, stroke, previous history of DVT) constituted a considerable part (33.3%, 12/36). Age, history of Diabetes Mellitus (DM), levels of DDi (D-Dimer), levels of alanine transferase (ALT) and left ventricular end-diastolic diameter (LVEDd) were independent predictors or risk factors of DVT in CHF patients, while chronic kidney disease (CKD) stage 1–4, white blood cell (WBC) and direct oral anticoagulant (DOAC) were protective factors. Incidence of DVT was correlated with a poor outcome of CHF patients (Pearson Chi-Square test, Value 19.612, P  <  0.001).

Conclusions

In this retrospective study, incidence of DVT was found to be relatively high among hospitalized CHF patients, while patients with DVT was associated with a poor prognosis.
Literature
1.
go back to reference Samama MM (2000) An epidemiologic study of risk factors for deep vein thrombosis in medical outpatients: the Sirius study. Arch Intern Med 160(22):3415–3420CrossRefPubMed Samama MM (2000) An epidemiologic study of risk factors for deep vein thrombosis in medical outpatients: the Sirius study. Arch Intern Med 160(22):3415–3420CrossRefPubMed
2.
go back to reference Ng TMH, Tsai F, Khatri N, Barakat MN, Elkayam U (2010) Venous thromboembolism in hospitalized patients with heart failure. Circ Heart Fail 3:165–173CrossRefPubMed Ng TMH, Tsai F, Khatri N, Barakat MN, Elkayam U (2010) Venous thromboembolism in hospitalized patients with heart failure. Circ Heart Fail 3:165–173CrossRefPubMed
3.
go back to reference Alikhan R, Spyropoulos AC (2008) Epidemiology of venous thromboembolism in cardiorespiratory and infectious disease. Am J Med 121:935–942CrossRefPubMed Alikhan R, Spyropoulos AC (2008) Epidemiology of venous thromboembolism in cardiorespiratory and infectious disease. Am J Med 121:935–942CrossRefPubMed
5.
go back to reference Piazza G, Seddighzadeh A, Goldhaber SZ (2008) Heart failure in patients with deep vein thrombosis. Am J Cardiol 101:1056–1059CrossRefPubMed Piazza G, Seddighzadeh A, Goldhaber SZ (2008) Heart failure in patients with deep vein thrombosis. Am J Cardiol 101:1056–1059CrossRefPubMed
6.
go back to reference Alikhan R, Cohen A, Combe S, Samama M, Desjardins L, Eldor A, Janbon C, Leizorovicz A, Olsson C, Turpie A (2003) Prevention of venous thromboembolism in medical patients with enoxaparin: a subgroup analysis of the MEDENOX study. Blood Coagul Fibrinolysis 14:341–346CrossRefPubMed Alikhan R, Cohen A, Combe S, Samama M, Desjardins L, Eldor A, Janbon C, Leizorovicz A, Olsson C, Turpie A (2003) Prevention of venous thromboembolism in medical patients with enoxaparin: a subgroup analysis of the MEDENOX study. Blood Coagul Fibrinolysis 14:341–346CrossRefPubMed
7.
go back to reference Fanola CL, Norby FL, Shah AM, Chang PP, Lutsey PL, Rosamond WD, Cushman M, Folsom AR (2020) Incident heart failure and long-term risk for venous thromboembolism. J Am Coll Cardiol 75:148–158CrossRefPubMedPubMedCentral Fanola CL, Norby FL, Shah AM, Chang PP, Lutsey PL, Rosamond WD, Cushman M, Folsom AR (2020) Incident heart failure and long-term risk for venous thromboembolism. J Am Coll Cardiol 75:148–158CrossRefPubMedPubMedCentral
8.
go back to reference Dries DL, Rosenberg YD, Waclawiw MA, Domanski MJ (1997) Ejection fraction and risk of thromboembolic events in patients with systolic dysfunction and sinus rhythm: evidence for gender differences in the studies of left ventricular dysfunction trials. J Am Coll Cardiol 29:1074–1080CrossRefPubMed Dries DL, Rosenberg YD, Waclawiw MA, Domanski MJ (1997) Ejection fraction and risk of thromboembolic events in patients with systolic dysfunction and sinus rhythm: evidence for gender differences in the studies of left ventricular dysfunction trials. J Am Coll Cardiol 29:1074–1080CrossRefPubMed
10.
go back to reference Melgaard L, Nielsen PB, Overvad TF, Skjøth F, Lip GYH, Larsen TB (2019) Sex differences in risk of incident venous thromboembolism in heart failure patients. Clin Res Cardiol 108:101–109CrossRefPubMed Melgaard L, Nielsen PB, Overvad TF, Skjøth F, Lip GYH, Larsen TB (2019) Sex differences in risk of incident venous thromboembolism in heart failure patients. Clin Res Cardiol 108:101–109CrossRefPubMed
11.
go back to reference Beemath A, Stein PD, Skaf E, Al Sibae MR, Alesh I (2006) Risk of venous thromboembolism in patients hospitalized with heart failure. Am J Cardiol 98:793–795CrossRefPubMed Beemath A, Stein PD, Skaf E, Al Sibae MR, Alesh I (2006) Risk of venous thromboembolism in patients hospitalized with heart failure. Am J Cardiol 98:793–795CrossRefPubMed
12.
go back to reference Ota S, Yamada N, Tsuji A, Ishikura K, Nakamura M, Ito M (2009) Incidence and clinical predictors of deep vein thrombosis in patients hospitalized with heart failure in Japan. Circ J 73:1513–1517CrossRefPubMed Ota S, Yamada N, Tsuji A, Ishikura K, Nakamura M, Ito M (2009) Incidence and clinical predictors of deep vein thrombosis in patients hospitalized with heart failure in Japan. Circ J 73:1513–1517CrossRefPubMed
13.
go back to reference Darze ES, Latado AL, Guimaraes AG, Guedes RA, Santos AB, de Moura SS, Passos LC (2005) Incidence and clinical predictors of pulmonary embolism in severe heart failure patients admitted to a coronary care unit. Chest 128:2576–2580CrossRefPubMed Darze ES, Latado AL, Guimaraes AG, Guedes RA, Santos AB, de Moura SS, Passos LC (2005) Incidence and clinical predictors of pulmonary embolism in severe heart failure patients admitted to a coronary care unit. Chest 128:2576–2580CrossRefPubMed
14.
go back to reference Tagalakis V, Patenaude V, Kahn SR, Suissa S (2013) Incidence of and mortality from venous thromboembolism in a real-world population: the Q-VTE study cohort. Am J Med 126(9):832.e13–21CrossRefPubMed Tagalakis V, Patenaude V, Kahn SR, Suissa S (2013) Incidence of and mortality from venous thromboembolism in a real-world population: the Q-VTE study cohort. Am J Med 126(9):832.e13–21CrossRefPubMed
15.
go back to reference White R, Zhou H, Murin S, Harvey D (2005) Effect of ethnicity and gender on the incidence of venous thromboembolism in a diverse population in California in 1996. Thromb Haemost 93:298–305CrossRefPubMed White R, Zhou H, Murin S, Harvey D (2005) Effect of ethnicity and gender on the incidence of venous thromboembolism in a diverse population in California in 1996. Thromb Haemost 93:298–305CrossRefPubMed
16.
go back to reference McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Bohm M, Burri H, Butler J, Celutkiene J, Chioncel O, Cleland J, Coats A, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam C, Lyon AR, McMurray J, Mebazaa A, Mindham R, Muneretto C, Francesco PM, Price S, Rosano G, Ruschitzka F, Kathrine SA (2021) 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 42:3599–3726CrossRefPubMed McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Bohm M, Burri H, Butler J, Celutkiene J, Chioncel O, Cleland J, Coats A, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam C, Lyon AR, McMurray J, Mebazaa A, Mindham R, Muneretto C, Francesco PM, Price S, Rosano G, Ruschitzka F, Kathrine SA (2021) 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 42:3599–3726CrossRefPubMed
17.
go back to reference Duncan DP, Taddonio M, Chang EY, Huang BK (2019) Characterization of intramuscular calf vein thrombosis on routine knee MRI. Skeletal Radiol 48:1573–1580CrossRefPubMed Duncan DP, Taddonio M, Chang EY, Huang BK (2019) Characterization of intramuscular calf vein thrombosis on routine knee MRI. Skeletal Radiol 48:1573–1580CrossRefPubMed
18.
go back to reference Rose S, Zwiebel W, Miller F (1994) Distribution of acute lower extremity deep venous thrombosis in symptomatic and asymptomatic patients. J Ultrasound Med 13:243–250CrossRefPubMed Rose S, Zwiebel W, Miller F (1994) Distribution of acute lower extremity deep venous thrombosis in symptomatic and asymptomatic patients. J Ultrasound Med 13:243–250CrossRefPubMed
19.
go back to reference Tebbe U, Schellong SM, Haas S, Gerlach HE, Abletshauser C, Sieder C, Bramlage P, Riess H (2011) Certoparin versus unfractionated heparin to prevent venous thromboembolic events in patients hospitalized because of heart failure: a subgroup analysis of the randomized, controlled CERTIFY study. Am Heart J 161:322–328CrossRefPubMed Tebbe U, Schellong SM, Haas S, Gerlach HE, Abletshauser C, Sieder C, Bramlage P, Riess H (2011) Certoparin versus unfractionated heparin to prevent venous thromboembolic events in patients hospitalized because of heart failure: a subgroup analysis of the randomized, controlled CERTIFY study. Am Heart J 161:322–328CrossRefPubMed
20.
go back to reference Cohen A, Davidson B, Gallus A, Lassen M, Prins M, Tomkowski W, Turpie A, Egberts J, Lensing A (2006) Efficacy and safety of fondaparinux for the prevention of venous thromboembolism in older acute medical patients: randomised placebo controlled trial. BMJ 332:325–329CrossRefPubMedPubMedCentral Cohen A, Davidson B, Gallus A, Lassen M, Prins M, Tomkowski W, Turpie A, Egberts J, Lensing A (2006) Efficacy and safety of fondaparinux for the prevention of venous thromboembolism in older acute medical patients: randomised placebo controlled trial. BMJ 332:325–329CrossRefPubMedPubMedCentral
21.
go back to reference Heit JA, Silverstein MD, Mohr DN, Petterson TM, O’Fallon WM, Melton LJ (2000) Risk factors for deep vein thrombosis and pulmonary embolism. Arch Intern Med 160:809CrossRefPubMed Heit JA, Silverstein MD, Mohr DN, Petterson TM, O’Fallon WM, Melton LJ (2000) Risk factors for deep vein thrombosis and pulmonary embolism. Arch Intern Med 160:809CrossRefPubMed
23.
go back to reference Howell MD, Geraci JM, Knowlton AA (2001) Congestive heart failure and outpatient risk of venous thromboembolism: a retrospective, case-control study. J Clin Epidemiol 54:810–816CrossRefPubMed Howell MD, Geraci JM, Knowlton AA (2001) Congestive heart failure and outpatient risk of venous thromboembolism: a retrospective, case-control study. J Clin Epidemiol 54:810–816CrossRefPubMed
24.
go back to reference Matsuo H, Matsumura M, Nakajima Y, Ogawa T, Tazaki J, Doi T, Yamada N, Koide T, Mo M, Suzuki T, Sarai N, Nakajima H (2014) Frequency of deep vein thrombosis among hospitalized non-surgical Japanese patients with congestive heart failure. J Cardiol 64: 430–4. Matsuo H, Matsumura M, Nakajima Y, Ogawa T, Tazaki J, Doi T, Yamada N, Koide T, Mo M, Suzuki T, Sarai N, Nakajima H (2014) Frequency of deep vein thrombosis among hospitalized non-surgical Japanese patients with congestive heart failure. J Cardiol 64: 430–4.
25.
go back to reference Di Nisio M, van Es N, Büller HR (2016) Deep vein thrombosis and pulmonary embolism. Lancet 388:3060–3073CrossRefPubMed Di Nisio M, van Es N, Büller HR (2016) Deep vein thrombosis and pulmonary embolism. Lancet 388:3060–3073CrossRefPubMed
26.
go back to reference Clagett G, Anderson F, Geerts W, Heit J, Knudson M, Lieberman J, Merli G, Wheeler H (1998) Prevention of venous thromboembolism. Chest 114:531S-560SCrossRefPubMed Clagett G, Anderson F, Geerts W, Heit J, Knudson M, Lieberman J, Merli G, Wheeler H (1998) Prevention of venous thromboembolism. Chest 114:531S-560SCrossRefPubMed
27.
go back to reference Engbers MJ, van Hylckama VA, Rosendaal FR (2010) Venous thrombosis in the elderly: incidence, risk factors and risk groups. J Thromb Haemost 8:2105–2112CrossRefPubMed Engbers MJ, van Hylckama VA, Rosendaal FR (2010) Venous thrombosis in the elderly: incidence, risk factors and risk groups. J Thromb Haemost 8:2105–2112CrossRefPubMed
29.
go back to reference Klein L, O’Connell JB (2007) Thromboembolic risk in the patient with heart failure. Curr Treat Options Cardiovasc Med 9:310–317CrossRefPubMed Klein L, O’Connell JB (2007) Thromboembolic risk in the patient with heart failure. Curr Treat Options Cardiovasc Med 9:310–317CrossRefPubMed
30.
go back to reference Sbarouni E, Bradshaw A, Andreotti F, Tuddenham E, Oakley C, Cleland J (1994) Relationship between hemostatic abnormalities and neuroendocrine activity in heart-failure. Am Heart J 127:607–12CrossRefPubMed Sbarouni E, Bradshaw A, Andreotti F, Tuddenham E, Oakley C, Cleland J (1994) Relationship between hemostatic abnormalities and neuroendocrine activity in heart-failure. Am Heart J 127:607–12CrossRefPubMed
31.
go back to reference Jug B, Vene N, Salobir BG, Šebeštjen M, Šabovic M, Keber I (2009) Procoagulant state in heart failure with preserved left ventricular ejection fraction. Int Heart J 50:591–600CrossRefPubMed Jug B, Vene N, Salobir BG, Šebeštjen M, Šabovic M, Keber I (2009) Procoagulant state in heart failure with preserved left ventricular ejection fraction. Int Heart J 50:591–600CrossRefPubMed
32.
go back to reference Buckheit D, Lefemine A, Sobieraj DM, Hobbs L (2021) Venous thromboembolism prophylaxis in underweight hospitalized patients. Clin Appl Thromb Hemost 27:10760296211018752CrossRefPubMedPubMedCentral Buckheit D, Lefemine A, Sobieraj DM, Hobbs L (2021) Venous thromboembolism prophylaxis in underweight hospitalized patients. Clin Appl Thromb Hemost 27:10760296211018752CrossRefPubMedPubMedCentral
33.
go back to reference Masotti L, Godoy DA, Napoli MD, Rabinstein AA, Paciaroni M, Ageno W (2012) Pharmacological prophylaxis of venous thromboembolism during acute phase of spontaneous intracerebral hemorrhage. Clin Appl Thromb Hemost 18:393–402CrossRefPubMed Masotti L, Godoy DA, Napoli MD, Rabinstein AA, Paciaroni M, Ageno W (2012) Pharmacological prophylaxis of venous thromboembolism during acute phase of spontaneous intracerebral hemorrhage. Clin Appl Thromb Hemost 18:393–402CrossRefPubMed
34.
go back to reference Jain H, Singh G, Kaul V, Gambhir HS (2022) Management dilemmas in restarting anticoagulation after gastrointestinal bleeding. Proc (Bayl Univ Med Cent) 35:322–327PubMed Jain H, Singh G, Kaul V, Gambhir HS (2022) Management dilemmas in restarting anticoagulation after gastrointestinal bleeding. Proc (Bayl Univ Med Cent) 35:322–327PubMed
35.
go back to reference Leonardi M, McGory M, Ko C (2006) The rate of bleeding complications after pharmacologic deep venous thrombosis prophylaxis—a systematic review of 33 randomized controlled trials. Arch Surg 141:790–797CrossRefPubMed Leonardi M, McGory M, Ko C (2006) The rate of bleeding complications after pharmacologic deep venous thrombosis prophylaxis—a systematic review of 33 randomized controlled trials. Arch Surg 141:790–797CrossRefPubMed
Metadata
Title
Incidence and characteristic of deep venous thrombosis in hospitalized chronic heart failure patients
Authors
Jia-Lin Yuan
Wen Kang Xiao
Chao Qiong Zhang
Le Sun
Ying Kang Lin
Chuang-Xiong Hong
Publication date
20-03-2024
Publisher
Springer Japan
Published in
Heart and Vessels
Print ISSN: 0910-8327
Electronic ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-024-02377-7