Susan R. Kahn, MD, MSc; Ian Shrier, MD, PhD; Jim A. Julian, MMath; Thierry Ducruet, MSc; Louise Arsenault, BA; Marie-José Miron, MD; Andre Roussin, MD; Sylvie Desmarais, MD; France Joyal, MD; Jeannine Kassis, MD; Susan Solymoss, MD; Louis Desjardins, MD; Donna L. Lamping, PhD; Mira Johri, PhD; Jeffrey S. Ginsberg, MD
Acknowledgment: The authors thank the VETO (VEnous Thrombosis Outcomes) study personnel at the clinical study sites for their dedication to this project.
Grant Support: By the Fonds de la recherche en santé du Québec and by an unrestricted grant-in-aid from GlaxoSmithKline. Drs. Kahn and Shrier are recipients of Senior Clinical Investigator Awards from the Fonds de la recherche en santé du Québec. Dr. Johri received a New Investigator Award from the Canadian Institutes of Health Research. Dr. Ginsberg received a Career Award from the Heart and Stroke Foundation of Ontario and holds the David Braley and Nancy Gordon Chair in Thromboembolic Disease at McMaster University.
Potential Financial Conflicts of Interest: None disclosed.
Reproducible Research Statement:Study protocol, statistical code, and data set: Available to approved individuals through written agreements with the author by contacting Dr. Kahn (e-mail, email@example.com.)
Requests for Single Reprints: Susan R. Kahn, MD, MSc, Centre for Clinical Epidemiology and Community Studies, Sir Mortimer B. Davis Jewish General Hospital, 3755 Cote Sainte Catherine, Room A-127, Montreal, Quebec H3T 1E2, Canada; e-mail, firstname.lastname@example.org.
Current Author Addresses: Drs. Kahn and Shrier, Mr. Ducruet, and Ms. Arsenault: Centre for Clinical Epidemiology and Community Studies, Sir Mortimer B. Davis Jewish General Hospital, 3755 Côte Sainte- Catherine, Room A-127, Montreal, Quebec H3T 1E2, Canada.
Mr. Julian: Department of Oncology, Henderson Research Centre,McMaster University, 711 Concession Street, Hamilton, Ontario L8V 1C3, Canada.
Drs. Miron, Roussin, and Joyal: Centre Hospitalier de l'Université de Montreal, Hôpital Notre-Dame, 1560 Rue Sherbrooke East, Montreal, Quebec H2L 4M1, Canada.
Dr. Desmarais: Centre Hospitalier Pierre Boucher, Jacques-Cartier Boulevard East, Longueuil, Quebec J4M 2A5, Canada.
Dr. Kassis: Hôpital Maisonneuve-Rosemont, 5415 De l'Assomption Boulevard, Montreal, Quebec H1T 2M4, Canada.
Dr. Solymoss: Division of Hematology, Montreal General Hospital, 1650 Cedar Avenue, Montreal, Quebec H3G 1A4, Canada.
Dr. Lamping: Health Services Research Unit, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom.
Dr. Johri: University of Montreal, 1420 Mont-Royal Boulevard, Montreal, Quebec H2V 4P3, Canada.
Dr. Ginsberg: McMaster University, 1200 Main Street West, Hamilton, Ontario L8N 3Z5, Canada.
Author Contributions: Conception and design: S.R. Kahn, D.L. Lamping, M. Johri, J.S. Ginsberg.
Analysis and interpretation of the data: S.R. Kahn, I. Shrier, J.A. Julian, T. Ducruet.
Drafting of the article: S.R. Kahn, I. Shrier.
Critical revision of the article for important intellectual content: S.R. Kahn, I. Shrier, J.A. Julian, A. Roussin, F. Joyal, J. Kassis, S. Solymoss, D.L. Lamping, M. Johri, J.S. Ginsberg.
Final approval of the article: S.R. Kahn, I. Shrier, J.A. Julian, M.-J. Miron, A. Roussin, S. Desmarais, F. Joyal, J. Kassis, S. Solymoss, M. Johri, J.S. Ginsberg.
Provision of study materials or patients: S.R. Kahn, M.-J. Miron, A. Roussin, S. Desmarais, F. Joyal, J. Kassis, S. Solymoss, J.S. Ginsberg.
Statistical expertise: J.A. Julian, T. Ducruet.
Obtaining of funding: S.R. Kahn.
Administrative, technical, or logistic support: S.R. Kahn, L. Arsenault, M.-J. Miron, A. Roussin, F. Joyal, J. Kassis, D.L. Lamping.
Collection and assembly of data: S.R. Kahn, T. Ducruet, L. Arsenault, M.-J. Miron, A. Roussin, F. Joyal, S. Solymoss, J.S. Ginsberg.
Kahn S., Shrier I., Julian J., Ducruet T., Arsenault L., Miron M., Roussin A., Desmarais S., Joyal F., Kassis J., Solymoss S., Desjardins L., Lamping D., Johri M., Ginsberg J.; Determinants and Time Course of the Postthrombotic Syndrome after Acute Deep Venous Thrombosis. Ann Intern Med. 2008;149:698-707. doi: 10.7326/0003-4819-149-10-200811180-00004
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Published: Ann Intern Med. 2008;149(10):698-707.
The postthrombotic syndrome is a chronic, burdensome consequence of deep venous thrombosis (DVT) that occurs despite optimal anticoagulant therapy (1). Typical symptoms include pain, heaviness, swelling, and cramping in the leg that are aggravated by standing or walking. In severe cases, venous ulcers, which are resistant to therapy and tend to recur, may develop, causing pain and suffering and incurring high costs to society (2, 3).
Compared with the large number of studies that have addressed the risk for recurrent thromboembolism after DVT, few studies have provided longitudinal data on the risk for the postthrombotic syndrome. Furthermore, why some patients with DVT develop this condition and others do not is poorly understood. To help address these gaps, we did a prospective, multicenter, cohort study of patients with acute DVT to describe the frequency, time course, and severity of the postthrombotic syndrome and to identify clinical and genetic determinants of this condition. We also aimed to identify predictors of recurrent venous thromboembolism.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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