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Deep vein thrombosis and its prevention in patients with acute myocardial infarction
I Prerovský1, P Niederle, J Simonová
1Institute for Clinical and Experimental Medicine, School of Medicine, Charles University, Prague, Czechoslovakia.
Insights
Moderate exercise significantly reduces venous thrombosis (VT) in acute myocardial infarction (AMI) patients. This study found exercise to be more effective than mini-heparin in preventing VT, highlighting its clinical importance.
Area of Science:
- Cardiology
- Vascular Medicine
- Preventive Medicine
Background:
- Venous thrombosis (VT) is a significant complication in patients with acute myocardial infarction (AMI).
- Identifying effective preventive strategies for VT in this high-risk population is crucial.
Purpose of the Study:
- To evaluate the efficacy of moderate exercise and mini-heparin in reducing the incidence of VT in patients with AMI.
- To identify patient-specific risk factors for VT development post-AMI.
Main Methods:
- A randomized controlled trial involving 408 patients with AMI.
- Three groups were studied: control, mini-heparin (2 x 5000 u. subcutaneously/24 h), and moderate exercise (hourly foot flexion exercises).
- Venous thrombosis was detected using 125I-labelled fibrinogen.
Main Results:
- The incidence of VT was 13.6% in the control group, 9% in the mini-heparin group (not statistically significant), and 5.1% in the exercise group (p < 0.05).
- Moderate exercise demonstrated a statistically significant reduction in VT incidence compared to the control group.
- Factors associated with increased VT risk included heart failure, prior thrombosis history, varices, and non-smoker status.
Conclusions:
- Moderate lower limb exercise is an effective and significant preventive measure against venous thrombosis in acute myocardial infarction patients.
- Exercise may be a superior strategy to mini-heparin for VT prevention in this cohort.
- Identifying and managing risk factors like heart failure and smoking status is important for VT prevention.
Abstract:
The incidence of venous thrombosis (VT) detected by 125I-labelled fibrinogen was followed in 408 patients with acute myocardial infarction (AMI). Patients were randomized into three groups: a group receiving small doses of heparin (2 X 5000 u. subcutaneously/24 h), and an exercise group (dorsal and plantar flexion of the foot for one minute each hour). VT was present in 13.6% of the control group, in 9% of the group with mini-heparin (an insignificant difference), and in 5.1% of the group with moderate exercise (p less than 0.05). VT was statistically significantly more frequent in patients with acute MI who had heart failure, thrombosis in their medical history, had varices and were non-smokers. The results indicate that even moderate exercise of the lower limbs decreases significantly the incidence of VT in patients with AMI.