[Acute-phase reactants and markers of inflammation in venous thromboembolic disease: correlation with clinical and evolution parameters]. / Reactantes de fase aguda y marcadores de inflamación en pacientes con enfermedad tromboembólica venosa: correlación con parámetros clínicos y evolutivos.

OBJECTIVE: To asses the association of acute reactants and interleukin 6 and 8 (IL-6 & IL-8) at diagnosis of venous thromboembolic disease (VTD) and clinical outcome. METHODS: 100 patients were diagnosed of VTD by image tests. Acute reactants (C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), fibrinogen), D-dimer and IL-6 and IL-8 we measured at the moment of diagnosis. We made a 12 month follow-up of these patients to notice any clinical evolution outcomes (recurrences, bleeding, post-phlebitic syndrome, death). RESULTS: IL-6 was increased in 9 patients and IL-8 in 3. The risk factors, time to diagnosis and pulmonary embolism rate were similar in both interleukin groups (normal and high levels). Fibrinogen levels were significantly increased in high IL-6 group (585 +/- 179 vs. 485 +/- 154 mgr/dl; p = 0.05). During follow-up there were 5 deaths, 3 recurrences, 11 bleedings and 43 postphlebitic syndromes. Normal ESR level was associated to postphlebitic syndrome (17.8 +/- 14.5 vs. 31.4 +/- 27.4 mm/1st h; p = 0.016). Patients who had high levels of IL-6 had worse survival than these with normal levels (p = 0.015). CONCLUSION: IL-6, ESR, and CPR at diagnosis of VTD could be useful to identified patients with higher risks of death and postphlebitic syndrome during the first year after diagnosis.

Reactantes de fase aguda y marcadores de inflamación en pacientes con enfermedad tromboembólica venosa: correlación con parámetros clínicos y evolutivos / Acute reactives and markers of inflammation in venous thromboembolic disease: clinical and evolution outcomes

Objetivo: Determinar si los reactantes de fase aguda, dímero D y las interleucinas 6 y 8 (IL-6 e IL-8) en el momento de diagnóstico de la enfermedad tromboembólica venosa (ETEV) se relacionan con alguna variable clínica y evolutiva relevante. Material y métodos: Se estudiaron 100 pacientes con el diagnóstico de ETEV por pruebas de imagen. Se determinaron reactantes de fase aguda (proteína C reactiva (PCR), velocidad de sedimentación globular (VSG) y fibrinógeno), dímero D así como IL-6 e IL-8 en el momento del diagnóstico. Se recogieron los eventos clínicos más relevantes (recurrencia, hemorragia, síndrome postflebítico y mortalidad) durante un período de seguimiento de 12 meses. Resultados: La IL-6 estaba elevada en 9 pacientes y la IL-8 en 3. Los factores de riesgo, la duración de los síntomas y la forma de presentación como embolismo pulmonar fueron similares entre los dos grupos. Los niveles de fibrinógeno estaban significativamente aumentados (585 ±179 vs. 485 ± 154 mg/dl; p = 0,05) en el grupo de pacientes con IL-6 elevada. En los 12 meses de seguimiento la frecuencia de fallecimientos, recurrencias, hemorragias y síndrome postflebítico fueron 5, 3, 11 y 43, respectivamente. La VSG normal se asoció de forma significativa a la aparición de síndrome postflebítico (17,8 ± 14,5 vs. 31,4 ± 27,4 mm/1ª h;p = 0,016). La supervivencia de los pacientes con cifras elevadas de IL-6 fue significativamente peor que la del resto de los pacientes (p = 0,015). Conclusiones: Niveles elevados de IL-6 y los reactantes de fase aguda (VSG y PCR) en el momento del diagnóstico de la ETEV podrían servirpara identificar a los pacientes con mayor mortalidad y mayor probabilidad de desarrollar un síndrome postflebítico durante el primer año

Objective: To assess the association of acute reactants and interleukin 6 and 8 (IL-6 & IL-8) at diagnosis of venous thromboembolic disease (VTD) and clinical outcome. Methods: 100 patients were diagnosed of VTD by image tests. Acute reactants (C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), fibrinogen), D-dimer and IL-6 and IL-8 we measured at the moment of diagnosis. We made a 12 month follow-up of these patients to notice any clinical evolution outcomes (recurrences, bledding, postphlebitic syndrome, death). Results: IL-6 was increased in 9 patients and IL-8 in 3. The risk factors, time to diagnosis and pulmonary embolism rate were similar in both interleukin groups (normal and high levels). Fibrinogen levels were significantly increased in high IL-6 group (585 ± 179 vs. 485 ± 154 mgr/dl; p=0.05). During follow-up there were 5 deaths, 3 recurrences, 11 bleedings and 43 postphlebitic syndromes. Normal ESR level was associated to postphlebitic syndrome (17.8 ± 14.5 vs. 31.4 ± 27.4 mm/1st ;;h; p=0.016). Patients who had high levels of IL-6 had worse survival than these with normal levels (p = 0.015). Conclusion: IL-6, ESR, and CPR at diagnosis of VTD could be useful to identified patients with higher risks of death and postphlebitic syndrome during the first year after diagnosis