Het ontstaan van post trombotisch syndroom.

Background:

Post thrombotic syndrome (PTS) is a chronic complication of deep venous thrombosis, associated with a decreased quality of life and at the same time posing a significant economic burden to society. Up until now the pathogenesis of PTS is not fully understood. Inflammation and fibrosis are thought to be the key players in the pathogenesis of this condition. Innate immunity may determine thrombus resolution and therefore influence the risk of PTS. Markers of inflammation, but also markers for fibrosis or fibrinolysis, may be of use to unravel the pathogenic processes involved in post thrombotic changes to the vessel wall. Finding associations between these markers and PTS can therefore help us to extend the knowledge on the pathogenesis of PTS.



Objective:

To investigate the role of innate immunity and fibrinolysis in developing PTS by studying the association between markers of immunity, fibrosis and fibrinolysis.



Study design:

Observational hypothesis generating study that is performed as a case-control study.



Study population:

The cases are a group of 30 patients who had a DVT 2-10 years ago and consequently developed PTS. The controls are a group of 30 patients who had a DVT 2-10 years ago, but did not develop PTS. The controls are matched on age, gender and BMI.

A second control group consists of healthy controls, 30 healthy people who have never had a DVT during their life. The patients will be recruited from the Maastricht University Medical Centre and the Flevohospital in Almere. As healthy controls partners, brothers, sisters, other relatives or friends of the patients will be asked.



Intervention:

The participants will be asked to visit the hospital once-only for 3 tubes of blood to be drawn.



Study parameters:

The plasma levels of a panel of markers in participants with PTS compared to participants without PTS.



Risks:

The risks for all subjects participating in this study are the risks of a normal venipuncture: hematoma or continued bleed at the place of puncture.

The markers CRP, D-dimer, Il-6, MCP-1, IFN-alfa, TLR-9, TGF-beta, MMP-2 or MMP-9 measured at least 2 year after the acute event of DVT are associated with PTS.

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