March is DVT Awareness Month
Increased knowledge could save lives
Ottawa doctors and researchers make important strides against deadly condition

What is DVT? Deep vein thrombosis occurs when a blood clot forms in the deep veins of the pelvis, leg or arm. Symptoms of deep vein thrombosis include pain, swelling, redness or warmth in the affected area. Deep vein thrombosis can lead to a more serious condition, called pulmonary embolism (PE).

What is PE? Pulmonary embolism occurs when a fragment from a vein blood clot (called an embolus) breaks off, travels through the blood system and lodges in the blood vessels of the lung. Pulmonary embolism can be life-threatening if it blocks the blood supply to the lung. Symptoms of pulmonary embolism include shortness of breath, chest pain that worsens with a deep breath, fast heart beat, sweating, fainting and coughing with blood in the sputum.

Venous thromboembolism (VTE) is one of the most common cardiovascular disorders in industrialized countries, affecting about 5% of people in their lifetime. The dangers of this condition are the highly fatal pulmonary embolism (PE), as well as bleeding consequences of treatment with anti-coagulants (often referred to as blood thinners) to prevent further events and post phlebitic syndrome (a painful chronic condition). Few people are aware of this condition or its dangerous effects. By publishing or broadcasting information on DVT, you are helping to save lives.

Quick DVT Facts (taken from www.preventdvt.org)

• DVT occurs in about 200,000 Canadians every year.
• PE is the leading cause of maternal death associated with childbirth. A woman's risk of developing Venous Thromboembolism (VTE) is six times greater when she is pregnant
• Pulmonary embolism causes more deaths annually in North America than breast cancer, AIDS and highway fatalities.
• Fatal PE may be the most common preventable cause of hospital death in North America
• Without preventive treatment, up to 60 percent of patients who undergo total hip replacement surgery may develop DVT.
• Cancer patients undergoing surgical procedures have at least twice the risk of postoperative DVT and more than three times the risk of fatal PE than non-cancer patients undergoing similar procedures.
• In the elderly, DVT is associated with a 21 percent one-year mortality rate, and PE is associated with a 39 percent one-year mortality rate.
• Up to 60,000 patients are hospitalized each year for DVT in Canada

Members of the Thrombosis Research Group at the Ottawa Hospital Research Institute, lead by Dr. Philip Wells, Canada Research Chair in Thromboembolic disease and Dr. Marc Rodger, Heart and Stroke New Investigator Award winner, have published several pivotal studies that have changed several practices in the diagnosis and management of venous thromboembolism (VTE). For example, they have demonstrated that routine screening for deep-vein thrombosis (DVT) post-surgery does not improve outcomes, and that nomograms improve control of anticoagulant therapy during initiation of warfarin, that outpatient treatment of patients with DVT or PE is safe and effective and that use of a clinical decision model and a simple blood test can safely rule out the presence of DVT without having to resort to expensive and inconvenient testing.

The Thrombosis Research Group at the Ottawa Hospital is currently involved in or leading over a dozen studies including:

• Treating pregnancy complications such as miscarriage, still birth, pre-eclampsia (pregnancy related high blood pressure), low birth weight babies and/or placental abruption in women with a genetic predisposition to developing blood clots
• Determining the genetic risk factors affecting siblings and first degree relatives (parents, brothers/sisters and children) of people with unexplained blood clots and how to treat them to prevent the development of a blood clot in the future
• Developing a safe and useful set of criteria to predict those patients with the lowest risk of developing a second blood clot after their first six months of treatment and who will not require treatment with blood thinners
• Attempting to determine if taking an anti-inflammatory for the first 30 days post DVT diagnosis, in addition to wearing compression stocking for two years, will result in fewer cases of PTS. Or in in cases where PTS does develop, if the effects will be less severe than those who did not receive treatment. Post-thrombotic syndrome (PTS) is a chronic, potentially debilitating complication of extremity deep venous thrombosis.
• Following 8000 pregnant women in Eastern Ontario to determine if Intrauterine Growth Restriction (IUGR), a condition in which the foetus doesn't grow as large as he or she should while in the uterus, and that carries an increased risk of perinatal mortality and morbidity, is linked to the genetic predisposition to develop blood clots.

For more information on DVT and to find out how Ottawa researchers are leading the way in new treatments contact:

Nathalie Trepanier
Communications Manager
OHRI
Tel:(613)798-5555 ext. 19691
Fax:(613)761-4920
ntrepanier@ohri.ca
www.ohri.ca

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