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New Developments in Venous Thromboembolic Disease Karen Hauer, MD University of California, San Francisco Outline • Diagnosis – VQ, Ultrasound, Helical CT, D-dimer • Risk factors • Treatment – Heparins – Warfarin: duration of treatment – New agents • Prophylaxis • IVC filters 48 year old woman presents with 2 weeks right LE pain, 2 days “trouble catching my breath.” PMH: dysfunctional uterine bleeding due to fibroids, recently treated with OCPs. PE: afebrile. BP 120/70, HR 110, RR 20, O2 95% RA. Normal chest & CV exam, CXR. What is your clinical suspicion of PE? What is your next diagnostic step? Clinical probability of PE Wells, Ann Intern Med 2001 Leg swelling, tenderness Pulse > 100 Immobilization, surgery Prior DVT/PE Hemoptysis Cancer No other more likely Dx < 2 = Low probability 2-6 = Moderate > 6 = High 3 1.5 1.5 1.5 1 1 3 VQ scan for PE PIOPED, 1990 Clinical Suspicion High VQ Intermed Low High 96% 88% 56% Intermed 66% 28% 16% Low 40% 16% 4% 0 6% 2% Normal Non-diagnostic in 640/887 (72%) patients Lower Extremity Veins Iliac Internal Saphenous (Superficial) Femoral Deep (Common) Femoral Popliteal External Saphenous Lower Extremity Ultrasound for PE • 90% PE’s originate in lower extremity DVT • 1st symptomatic DVT – Sensitivity 95%, specificity 96% – Increased sensitivity: • serial US at 5-7 days • combining with clinical suspicion Ultrasound after Non-diagnostic VQ • After non-diagnostic lung scan, serial US has NPV of 99.5% (Wells, Ann Intern Med, 1998) – Avoids angiogram • 71% vs. 29% require angio (Stein, Arch Intern Med, 1995) • Caution: – – – – Recurrent DVT: 50% US still abnormal at 1 year Asymptomatic DVT: lower sensitivity Isolated calf DVT: lower sensitivity Serial US not for high cardiopulmonary risk D-dimers: what is the role? • D-dimer: degradation product of cross-linked fibrin • The appeal: a simple blood test • High sensitivity, low specificity • Quantitative D-dimer < 500 ng/ml makes PE less likely • Elevated d-dimer common w/o clot - especially • Cancer • Post-op • Pregnancy • Inpatients • Prior DVT D-dimers: use selectively • Multiple assays • Can’t generalize from one to another • Goal: high negative predictive value • To rule out clot • Use D-dimers with clinical suspicion or other testing – In outpatients, ED D-dimers Pretest probability (930 ED patients) Low: n=527 (57%) D-dimer (-) N=437 (47%) No PE Not low: n=403 (43%) D-dimer +VQ (+) VQ Wells, Ann Intern Med, 2001 The Role of Helical CT in Diagnosing PE Where does Helical CT fit into the algorithm? Suspected PE V/Q scan 60-70% nondiagnostic Serial US unsafe if unstable patient Angiography invasive D-dimer negative may rule out PE Helical CT: Reviewing the Evidence Rathbun, Ann Intern Med 2000 Mullins, Arch Intern Med 2000 Rathbun Sensitivity 53% - 100% Specificity 81% - 100% • Limitations Mullins 64% - 93% 89% - 100% – Include subsegmental PE? • Sensitivity for central PE = 83% - 100%, PPV = 95% • Sensitivity for subsegmental PE = 29% – Variations in quality of technology, reader CT: the Primary Diagnostic Test? van Strijen, Ann Intern Med 2003 510 patients with suspected PE Helical CT PE 124 (24%) alternate Dx 130 (26%) normal 248 (49%) 2 DVT on US Helical CT: Evidence-based Practice • Does a normal helical CT rule out PE? – Enough to withhold anticoagulation? Stop workup? – Yes. • Does a positive helical CT rule in PE? – Yes, no need for further testing. – At centers with CT experience - radiology, scanner The Role of Helical CT in Diagnosing PE Stable patient Equivocal V/Q <-Helical CT Suspected PE -->Unstable patient: Helical CT V/Q scan Serial US Angiography D-dimer A 48 year old Caucasian woman recently started on OCPs presents with symptoms of acute DVT and PE. V/Q scan is high probability for PE, LE ultrasound is diagnostic of DVT, and helical CT shows a saddle PE. You initiate anticoagulation, stop the OCP’s, and consider whether she has a hypercoagulable state. Do you. . . A. Send protein C, protein S, antithrombin III levels B. “Pan scan” for malignancy C. Test for Factor V Leiden, prothrombin mutation D. All of the above E. None of the above Clues to Inherited Hypercoagulability • Age < 50 • Unusual location or severity • “Idiopathic” thrombosis – BUT, inherited disorders augment other risks - i.e. surgery, pregnancy • Recurrent thrombosis • Family history Inherited Hypercoagulability Factor V Leiden Prothrombin mutation Homocysteinemia Prevalence Prevalence Diagnosis with VTE w/o VTE 12-21% 6% PCR 6-8% Protein C, S 2-4% deficiency Antithrombin III 1-2% deficiency Any thrombophilia 24-37% 2% PCR Homocysteine level < 1% <1% Pro C, S levels ATIII level 10% Antiphospholipid antibody: ACLA, PTT or other twice over 6 weeks Acquired risk factors: oral contraceptives 35 30 25 Relative risk 20 15 10 5 0 1st/2nd gen prog 3rd gen FV Leiden OCP + FV Leiden Screening for hypercoagulability before oral contraceptives Pro Con • Thrombophilia common • PE: high morbidity, mortality • Cost • Risk of clot low • Difficulty predicting who will clot • H/o DVT/PE: already a contraindication • May still miss thrombophilia Acquired risk factors - cancer Risk of cancer after PE/DVT 3 2 Relative risk 1 0 <6 >6 months after PE/DVT • Cancer in patients with DVT/PE: – Higher risk of metastases, worse prognosis – Recommendation: careful H & P, routine cancer screening Sorensen, NEJM 2000 A healthy 48 year old with acute DVT and PE is treated with warfarin and heparin. Potential benefits of LMWH for this patient include all of the following except: A. B. C. D. Fewer lab tests Potential for home therapy Reduced mortality risk Easier reversal of anticoagulation in case of bleeding E. Lower risk of heparin induced-thrombocytopenia LMWH Advantages • Longer half life • No need to monitor PTT • Better bioavailability after SQ injection • Less heparin-induced thrombocytopenia • Less osteoporosis • Better outcomes with cancer Disadvantages • Incompletely reversed by protamine • Unpredictable response with renal failure, obesity LMWH vs. UFH: 13 Studies Dolovich, Arch Int Med 2000 DVT/PE PE Major bleeding Minor bleeding Total mortality Thrombocytopenia 1.00 Pooled Relative Risk LMWH better 0.50 1.50 UFH better Treating to prevent Post thrombotic syndrome • Venous insufficiency after DVT • Risk factors – Elderly – Recurrent DVT – Obesity – Proximal thrombosis • Chronic pain, edema, ulcers, skin discoloration Compression hose prevent post thrombotic syndrome • 1st proximal DVT, anticoagulated >= 3 months • Intervention – Below-knee elastic stocking on affected leg for 2 years, started 5-10 days after DVT diagnosis • Stockings reduced post thrombotic syndrome: – 49% vs. 26% (NNT = 4 to prevent 1 case) – Compression hose well tolerated – No difference in rate of recurrent DVT Prandoni, Ann Intern Med 2004 Duration of Treatment: VTE as a Chronic Disease Recurrence rate 45 40 35 30 25 20 15 10 5 0 1st VTE Warfarin 3 mo Warfarinextended Recurrent VTE 6 12 18 months 24 Warfarin 6 mo Warfarinextended Kearon, NEJM, 1999 Schulman, NEJM 1997 Warfarin for Secondary Prevention after Idiopathic DVT/PE • Placebo Recurrence/year 7% Bleeding/year • INR 1.5-2 2-2.6% 1% • INR 2-3 0.6% 1% PREVENT, NEJM 2003 ELATE, Blood 2003 Duration of Treatment Guidelines 1st event, reversible risk factor 3-6 months 1st event, spontaneous >= 6 months 2nd event >=12 months or lifelong Lifelong 2nd spontaneous event, or 1st spontaneous and life threatening 3rd event or Ongoing risk factors Lifelong The Decision to Stop Warfarin: • Risk factors for clot recurrence 1. Initial clot burden 2. Modifiable vs. persistent, major vs. minor 3. Thrombophilia • Indicators of increased risk – Elevated d-dimers 1 mo after stopping anticoag – Residual thrombosis on ultrasound after anticoag – Other markers of coagulation activity ACCP 2004 Hron, JAMA 2006 Young, J Thromb Haemost 2006 Inherited risk factors and recurrent venous thromboembolism Meta-analysis of 10 studies evaluating risk of recurrent clot in 3000 patients after anticoagulation stopped - with or without genetic mutation Factor V Leiden 21% of patients Odds of recurrence: 1.4 Prothrombin G20212A 10% of patients Odds of recurrence: 1.7 Elevated risk, but not enough to warrant lifelong anticoagulation Ho, Arch Intern Med, 2006 recurrent clot (%) Treatment of Thromboembolism with Cancer: LMWH Superior 20 18 16 14 12 10 8 6 4 2 0 Dalteparin Warfarin 1 2 3 4 months 5 6 7 Lee. NEJM 2003 Thrombosis in Pregnancy A 34 year old woman G1 who is 35 weeks pregnant presents with left leg swelling, dyspnea, and right sided pleuritic chest pain. How do you proceed? A. Reassure her - these are common symptoms in pregnancy B. MRI of the lower extremities C. D-dimer D. V/Q scan E. IV Heparin Thrombosis in Pregnancy • Challenges in diagnosis – Edema, tachypnea, dyspnea common – D-dimer levels rise during pregnancy • Test as you would for non-pregnant patient – Ultrasound for DVT, PE • Consider MRI – V/Q or CT for PE • Treat with LMWH, heparin, fondaparinux On the horizon. . . New therapies • Fondaparinux – Synthetic Factor Xa inhibitor – FDA approved for prophylaxis, treatment • Prophylaxis: 2.5/d SQ • Treatment: weight based 5, 7.5 or 10/d SQ – Start warfarin simultaneously, continue 5-7 days as with heparin • Avoid with GFR < 30 Off the horizon 2006. . . Ximelagatran • Direct thrombin inhibitors • Alternative to warfarin – Oral - fixed dose • Acute clot or orthopedic prophylaxis: 36 mg bid • Secondary prevention: 24 mg bid – No monitoring, no initial heparin • Safety questions – No antidote – Can elevate LFTs Preparing for surgery Deemed no longer a candidate for estrogens, the patient is scheduled for hysterectomy due to menorrhagia worsened on anticoagulation. What DVT prophylaxis do you recommend? A. B. C. D. Ted hose, early ambulation IV heparin UFH 5000 u SQ bid Enoxaparin 30 mg SQ bid + ted hose, early ambulation DVT prophylaxis: Surgery • Low risk – Age < 40 AND surgery <30 min • Moderate risk – Non major surgery or age 40-60 or other risks* • High risk – Age >60, LE ortho or cancer surgery, other risks* *e.g. thrombophilia, CHF, malignancy DVT prophylaxis: Surgery • Low risk – Early ambulation • Moderate risk – UFH 5000 u SQ bid or LMWH, IPC, ted hose • High risk – LMWH - may combine with IPC, ted hose LMWH in Medical Patients at Moderate Risk for DVT Samama, NEJM. 1999 • 866 patients: respiratory failure, infection, CHF, treated 6-14 days – DVT at day 14: • enoxaparin 40 mg/dy: 5.5% • enoxaparin 20 mg/dy, placebo: 15%(p = 0.001) – Similar mortality, side effects BUT. . . mostly asymptomatic, distal DVT no UFH comparison group Preventing DVT in Medical Patients • UFH or LMWH effective – 60% risk reduction in DVT, PE – Borderline decrease in hemorrhage with LMWH • Target high risk patients – CHF – Severe respiratory disease – Bedridden plus additional risk factor • Consider compression hose for low risk patients Case A 30 year old woman with ulcerative colitis is admitted with bloody diarrhea. On day 3 she develops dyspnea and hypoxia. Helical CT reveals PE. What is the best management strategy: A. B. C. D. Unfractionated heparin, goal aPTT 50-60, followed by LMWH IVC filter, avoid anticoagulation IVC filter, initiate anticoagulation when bleeding controlled Unfractionated heparin, warfarin with goal INR 1.5-2 Indications for IVC filter • Clot with active bleeding • Clot despite anticoagulation • Massive PE with chronically compromised pulmonary vasculature? • Prevention? IVC filters: benefits and risks Decousus, NEJM 1998 400 patients with proximal DVT, 50% with PE PE at day 12 PE at 2 years DVT at 2 years Death Major bleed Filter No filter 1% 3% 21% 22% 9% 5% 6% 12% 21% 12% p 0.03 NS 0.02 NS NS Retrievable IVC filters • FDA approved • Ideal for young patients with reversible PE risk factors • Left in, they become permanent – Current duration < 2 weeks Summary • Diagnosis – Combine clinical suspicion, test results • Risk factors – Higher yield for inherited thrombophilia • Treatment – LMWH as good, possibly superior to UFH – Warfarin: Longer treatment course • Prophylaxis – Risk stratify