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Abstract Number: 1875

Deep Vein Thrombosis and Pulmonary Embolism in Systemic Sclerois

Nabil Hakami1,2 and Sindhu R. Johnson3, 1Rheumatology, Toronto Scleroderma Program,Toronto Western Hospital, Mount Sinai Hospital,, Toronto, ON, Canada, 2King Fahad Central Hospital, Riyad, Saudi Arabia, 3Toronto Scleroderma Program, Toronto Western Hospital, Mount Sinai Hospital, University of Toronto, University Health Network Pulmonary Hypertension Programme, Toronto, ON, Canada

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: Systemic sclerosis

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Session Information

Date: Monday, November 9, 2015

Title: Systemic Sclerosis, Fibrosing Syndromes and Raynaud's - Clinical Aspects and Therapeutics Poster II

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: In systemic sclerosis (SSc) vasculopathy causes frequent episodes of reperfusion injury and free radical mediated endothelial dysfunction, which may influence the onset of local thrombotic complications. Venous thromboembolism (VTE)  is a vascular phenomenon that includes deep vein thrombosis (DVT) and pulmonary embolism (PE). The objectives of this study are to evaluate the prevalence of DVT and PE in SSc and evaluate risk factors for the development of PE or DVT in SSc patients.

Methods: We conducted a retrospective cohort study of patients who fulfilled the ACR–EULAR classification criteria for SSc attending the Toronto Scleroderma Program (Toronto Western Hospital, Mount Sinai Hospital, Toronto General Hospital) between 1970 – 2015. DVT was defined as the presence of thrombus on doppler ultrasound of either upper or lower extremity. PE was defined as the presence of thrombus on CT angiogram of the thorax.

Results: 927 SSc patients were included (761 females, 166 males). There were 31 (1.6%) VTE events, which is 10 times more frequent than would be expected in the general population. The prevalence of DVT was 16/927 (1.7%) and PE was 19/927 (2.1%). Anticardiolipin antibody was present in 1 patient with PE. Lupus anticoagulant was not present in any of the patients with VTE events. Patients with ILD more frequently experienced DVT (RR 2.85 95%CI (1.08, 7.54) but not PE (RR 1.82 (95%CI 0.89, 3.70). There was no significant difference in the occurrence of DVT or PE between SSc subtype (relative risk (RR) 0.95 (95%CI 0.46, 1.97), RR1.1 (95%CI 0.62, 2.04)), or presence of  cancer (RR 2.48, (95%CI 0.81, 7.5), RR 0.87 (95%CI 0.20, 3.73), respectively.

Conclusion: Although uncommon, DVT and PE appear to occur more frequently in SSc. DVT occurs more frequently in SSc-ILD patients. VTE do not appear to be related to a hypercoagulable state.


Disclosure: N. Hakami, None; S. R. Johnson, None.

To cite this abstract in AMA style:

Hakami N, Johnson SR. Deep Vein Thrombosis and Pulmonary Embolism in Systemic Sclerois [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/deep-vein-thrombosis-and-pulmonary-embolism-in-systemic-sclerois/. Accessed .
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