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Órgano Oficial de la Sociedad Mexicana de Angiología y Cirugía Vascular

2015, Number 2

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Rev Mex Angiol 2015; 43 (2)

Asociación de la elevación de la proteína C reactiva con la escala de Villalta

Gutiérrez-Díaz CA, Absalón-de-Alba D, Torres-Martínez JA, Serrano-Lozano J

Language: Spanish
References: 29
Page: 40-60
PDF size: 252.22 Kb.


ABSTRACT

Introduction. After acute deep venous thrombosis patients are at increased risk for development of post-thrombotic syndrome. Factors that contribute to the development and progression of the disease include chronic ambulatory venous hipertension leading to disturbances in the venous microcirculation. There is increasing clinical and experimental evidence that inflammatory processes have a pivotal role in the setting of post-thrombotic syndrome. However, inflammation markers have not yet been investigated in patients after deep venous thrombosis in relation to their clinical mid term to long term outcome. An attractive area of research involves biomarkers to stratify patients at risk of post-thrombotic syndrome after deep venous thrombosis. Several biomarkers correlate with less complete thrombus resolution like C reactive protein, suggesting more severe post-thrombotic syndrome.
Objective. To demonstrate that the elevation of C reactive protein is in relation with the elevation in the Villalta score.
Material and methods. With the permission of the Ethics and Research Committee of the Hospital Regional Lic. Adolfo López Mateos we started a non randomized clinical assay, prospective, comparative, opened, applied and bioethical. We studied patients of any age that arrived to the Vascular Surgery Department with the diagnosis of deep venous thrombosis. Informed consent was required by the patient and the patient’s responsible family. The C reactive protein levels and Villalta scale were measured 6 months after deep venous thrombosis and we create two groups on the basis of C reactive protein levels: high C reactive protein and low C reactive protein. Once the data was recollected, both groups where compared by a stadistical program (SPSS) to determine the relation between elevation of C reactive protein and elevation of Villalta scale.
Results: A total of 40 patients were studied, 21 where from the high C reactive protein group and 19 from the low C reactive protein group. The average age for the patients from the high C reactive protein group was 63.6 years old and for the low C reactive protein group 58.5 years old. The mayority of the patients where male with a percentage of 61.9% male and 38.1% female in the high C reactive protein group and 52.6% male and 47.4% female in the low C reactive protein group. The main anatomical site of thrombosis was femoropopliteal in both groups, 52.4% in the high C reactive protein group and 94.7% in the low C reactive protein group. The main cause of thrombosis was idiopathic. The majority of patients were treated with vitamin K antagonists followed by low molecular weight heparin and rivaroxaban. The mean treatment duration was 6 months. All the post-thombotic syndrome symptoms and signs were recorded. The patients in the high C reactive protein group had higher levels of C reactive protein: 9.3 mg/dL with a mean Villalta score of 9.9 (p ‹ 0.05). The patients in the low C reactive protein group had lower levels of C reactive protein: 1.6 mg/dL with a mean Villalta score of 2.8 (p ‹ 0.05).
Conclusion: The results of this study shown that the elevation of C reactive protein is in relation with the Villalta scale elevation. The deep venous thrombosis anatomical site had an impact on the postthrombotic syndrome appearance. Patients with iliofemoral localization have higher risk of postthrombotic syndrome.


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