Venous Thromboembolism in Patients with Diabetes Mellitus
American Journal of Medicine, 06/22/2012
Piazza G et al. – Patients with diabetes who developed venous thromboembolism were more likely to suffer a complicated clinical course. Diabetes was an independent predictor of recurrent deep vein thrombosis. The authors observed a low rate of thromboprophylaxis in diabetic patients.Methods
- The authors studied diabetic patients in the population–based Worcester Venous Thromboembolism Study of 2488 consecutive patients with validated venous thromboembolism.
- Of 2488 venous thromboembolism patients, 476 (19.1%) had a clinical history of diabetes.
- Thromboprophylaxis was omitted in more than one third of diabetic patients who had been hospitalized for non–venous–thromboembolism–related illness or had undergone major surgery within 3 months before diagnosis.
- Patients with diabetes were more likely than nondiabetic patients to have a complicated course after venous thromboembolism.
- Patients with diabetes were more likely than patients without diabetes to suffer recurrent deep vein thrombosis (14.9% vs 10.7%) and long–term major bleeding complications (16.4% vs 11.7%) (all P=.01).
- Diabetes was associated with a significant increase in the risk of recurrent deep vein thrombosis (adjusted odds ratio [AOR] 1.74; 95% confidence interval [CI], 1.21–2.51).
- Aspirin therapy at discharge (AOR 1.59; 95% CI, 1.1–2.3) and chronic kidney disease (AOR 2.19; 95% CI, 1.44–3.35) were independent predictors of long–term major bleeding.