To access this material please log in or register

Register Authorize

Chronic heart failure in patients with venous thromboembolic complications. Influence on D-dimer levels, efficacy and safety of long-term anticoagulant therapy

Vorobieva N. M.1, Panchenko E. P.1, Dobrovolskiy A. B.1, Titaeva E. V.1, Ermolina O. V.1, Balakhonova T. V.1, Kirienko A. I.2
1 - Federal State Budgetary Institution, “Russian Cardiology Research and Production Complex” of the RF Ministry of Health Care, 3rd Cherepkovskaya 15a, Moscow 121552
2 - State Budgetary Educational Institution of Higher Professional Education, “N.I. Pirogov Russian National Research Medical University” of the RF Ministry of Health Care, Ostrovityanova 1, Moscow 117997

Keywords: anticoagulants, venous thromboembolic events, d-dimer, CHF

DOI: 10.18087/rhfj.2012.1.1642

Relevance. Chronic HF is a procoagulant condition and independent uncorrectable risk factor of venous thromboembolic events (VTE). Objective. Study of CHF influence on D-dimer levels, efficacy and safety of long-term anticoagulant therapy in patients who had VTE. Materials and methods. The study included 97 patients with VTE (67 male, 30 female) at the age of 18–76 years, who had suffered the first or repeated deep vein thrombosis (DVT) and / or pulmonary embolism event, who had no contraindications for anticoagulant therapy. All patients received unfractioned or low molecular weight heparin with subsequent transfer to warfarin with control of international normalized ratio (targeted INR values 2.0–3.0). US angio scan of extremities was performed and D-dimer levels were measured initially, in 1, 3, 6, 12, and 18 months. Results. CHF did not increase risk of hemorrhagic complications, but was not associated with increased risk of DVT recurrence (relative risk 3.8) and increased levels of D-dimer (relative risk 3.3) during anticoagulant therapy in comparison with VTE patients without CHF.
  1. Samama MM. An epidemiologic study of risk factors for deep vein thrombosis in medical outpatients: the Sirius study. Arch Intern Med. 2000;160 (22):3415–3420.
  2. Howell MD, Geraci JM, Knowlton AA. Congestive heart failure and outpatient risk of venous thromboembolism: a retrospective, case-control study. J Clin Epidemiol. 2001;54 (8):810–816.
  3. Heit JA, Silverstein MD, Mohr DN et al. Risk factors for deep vein thrombosis and pulmonary embolism: a population-based case-control study. Arch Intern Med. 2000;160 (6):809–815.
  4. Grady D, Wenger NK, Herrington D et al. Postmenopausal Hormone Therapy Increases Risk for Venous Thromboembolic Disease. The Heart and Estrogen / progestin Replacement Study. Ann Intern Med. 2000;132 (9):689–696.
  5. Bergmann JF, Mahe I. Prevention of deep venous thrombosis in medical patients. Ann Med Interne. 2000;151 (3):207–214.
  6. Baron JA, Gridley G, Weiderpass E et al. Venous thromboembolism and cancer. Lancet. 1998;351 (9109):1077–1080.
  7. Российские клинические рекомендации по диагностике, лечению и профилактике венозных тромбоэмболических осложнений. Флебология. 2010;4 (1):37.
  8. Kearon C, Kahn SR, Agnelli G et al. Antithrombotic therapy for venous thromboembolic disease: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008;133 (6 Suppl):454S-545S.
  9. Fihn SD, McDommel M, matin D et al. Risk factors fоr complications of chronic anticoagulation. A multicenter study. Warfarin Optimized Outpatient Follow-up Study Groop» Ann Intern Med. 1993;118 (7):511–520.
  10. Zhu T, Martinez I, Emmerich J. Venous thromboembolism: risk factors for recurrence. Arterioscler Thromb Vasc Biol. 2009;29 (3):298–310.
  11. Spencer FA, Gore JM, Lessard D. et al. Patient outcomes after deep vein thrombosis and pulmonary embolism: the Worcester Venous Thromboembolism Study. Arch Intern Med. 2008;168 (4):425–430.
  12. Piazza G, Goldhaber SZ, Lessard DM et al. Venous thromboembolism in heart failure: preventable deaths during and after hospitalization. Am J Med. 2011;124 (3):252–259.
  13. Prandoni P, Noventa F, Ghirarduzzi A et al. The risk of recurrent venous thromboembolism after discontinuing anticoagulation in patients with acute proximal deep vein thrombosis and pulmonary embolism. A prospective cohort study in 1,626 patients. Haematologica. 2007;92 (2):199–205.
  14. Patel MR, Mahaffey KW, Garg J et al. for the ROCKET AF Investigators. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med. 2011;365 (10):883–891.
  15. Мареев В. Ю., Агеев Ф. Т., Арутюнов Г. П. и др. Национальные рекомендации ВНОК и ОССН по диагностике и лечению ХСН (третий пересмотр). Журнал Сердечная Недостаточность. 2010;11 (1):3–62.
  16. Dickstein K, Cohen-Solal A, Filippatos G et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM). Eur Heart J. 2008;29 (19):2388–2442.
  17. Cugno M, Mari D, Meroni PL et al. Haemostatic and inflammatory biomarkers in advanced chronic heart failure: role of oral anticoagulants and successful heart transplantation. Br J Haemotol. 2004;126:85–92.
  18. Jug B, Vene N, Salobir BG et al. Procoagulant state in heart failure with preserved left ventricular ejection fraction. Int Heart J. 2009;50: 591–600.
  19. Marcucci R, Gori AM., Giannotti F et al. Markers of hypercoagulability and inflammation predict mortality in patients with heart failure. J Thromb Haemost. 2006;4 (5):1017–1022.
  20. Jug B, Vene N, Salobir BG et al. Prognostic impact of haemostatic derangements in chronic heart failure. Thromb Haemost. 2009;102 (2):185–187.
  21. Воробьева Н. М., Добровольский А. Б., Титаева Е. В. и др. Значимость Д-димера как маркера декомпенсации хронической сердечной недостаточности. журнал Сердечная Недостаточность. 2011;12 1):52–57.
  22. Timinski U, Rabe E. Results of the D-dimer test during the anticoagulation therapy of deep vein thrombosis. Vasomed. 1999; (Suppl 1) 49.
  23. Elias A, Bonfils S, Daoud-Elias M et al. Influence of long term oral anticoagulants upon prothrombin fragment 1+2, thrombin-antithrombin III complex and D-dimer levels in patients affected by proximal deep vein thrombosis. Thromb Haemost. 1993;69:302–305.
  24. Воробьева Н. М., Панченко Е. П., Андрияшкин В. В. и др. Факторы, определяющие эффективность антикоагулянтной терапии у больных с венозными тромбоэмболическими осложнениями. Флебология. 2010;4 (3):13–20.
  25. Воробьева Н. М., Панченко Е. П., Добровольский А. Б. и др. Независимые предикторы рецидива тромбоза глубоких вен (результаты проспективного 18‑месячного наблюдения). Кардиология. 2010;50 (12):52–58.
  26. Vorobyeva NM, Dobrovolsky AB, Titaeva EV et al. Prognostic value of D-dimer in patients with venous thromboembolism. J Thromb Haemost. 2011;9 (Suppl 2):862.
Vorobieva N. M., Panchenko E. P., Dobrovolskiy A. B. et al. Chronic heart failure in patients with venous thromboembolic complications. Influence on D-dimer levels, efficacy and safety of long-term anticoagulant therapy. Russian Heart Failure Journal. 2012;13(1):53-59

To access this material please log in or register

Register Authorize
Ru En