2007 Deep Vein Thrombosis (DVT) Awareness Program Know Your Risk

DVT Blood Clots: A Potentially Fatal Health Problem 1/Gerotziafas.Curr Opin Pulm Med.2004/ P356/C2/Line11 1/Gerotziafas.Curr Opin Pulm Med.2004/ P356/C2/Line13 P356/C2/Lines 4,5 2/Heit.ASH Meeting. 2005/P1/table 2/Heit.ASH Meeting.2005/P1/table 3/Thom.Circulation. 2006/Pe87/C2/Line16 3/Thom.Circulation. 2006/Pe87/C2/Line20 Up to 2 million people in the United States suffer from DVT blood clots every year1 Approximately 600,000 experience pulmonary embolism (PE)1 In the US, complications from DVT blood clots kill almost 300,000 people a year — more than AIDS and breast cancer combined1,2 Some causes of death in the US Annual number of deaths PE Almost 300,0002 AIDS 13,5443 Breast cancer 41,5663 Gerotziafas and Samama. Curr Opin Pulm Med. 2004;10:356-365. Heit et al, on behalf of the VTE Impact Assessment Group. Poster #68. Presented at: 47th Annual Meeting and Exposition, American Society of Hematology; December 10-13, 2005; Atlanta, Ga. Thom et al. Circulation. 2006;113:85-151.

What Is DVT? DVT is a blood clot that forms in a vein deep in the body Most often occurs in the deep veins of the legs, either above the knee or below it The blood clot or part of it may break free (called an emboli) and become lodged in the blood vessels of the lung, causing PE

Talk to Your Doctor It is important to share your concerns about DVT blood clots with your doctor Ask questions and be prepared to provide accurate information about your lifestyle, diet, exercise routine, and medications, including over-the-counter drugs If your mobility is restricted due to illness or surgery, or if you have ever had a blood clot, you should talk to your doctor about preventing DVT

Some Risk Factors for DVT Some of the risk factors that may increase your risk of DVT are4,5: 4/Caprini.Scope Phlebol Lymphol. 2001/P228/C2/ L105/APHA.2003/ P4/table Age 40 years or older Being overweight A personal or family history of blood clots Birth control pills Hormone replacement therapy (HRT) Cancer Certain heart problems Respiratory failure Varicose veins Pregnancy Surgery, especially hip, knee, or abdominal surgery Currently have restricted mobility due to a long illness or surgery The more risk factors you have, the greater your chances of developing DVT 4. Caprini and Arcelus. Scope Phlebol Lymphol. 2001;8:228-240. 5. American Public Health Association. Presented at: Public Health Leadership Conference on Deep-Vein Thrombosis: February 26, 2003: Washington, DC.

Symptoms of DVT and PE The majority of people with DVT do not have symptoms6 6/Geerts.Chest. 2001/P132S/C1/ L23 5/APHA/P5/C1/table 7/www.nhlbi.com/ P2/L35;P3/L3 DVT 5,7 Swelling of the leg Pain or tenderness in the leg; the pain is usually in 1 leg and may only be present when standing or walking Leg feels warm to the touch Red or discolored skin PE5,7 Unexplained shortness of breath Chest pain or palpitations Anxiety and/or sweating Coughing up blood Fatigue and/or fainting 5. American Public Health Association. Presented at: Public Health Leadership Conference on Deep-Vein Thrombosis: February 26, 2003: Washington, DC. 6. Geerts et al. Chest. 2001;119(suppl):132S-175S. 7. National Heart, Lung, and Blood Institute. Available at: http://www.nhlbi.nih.gov/health/dci/Diseases/pe/pe_all.html. Accessed September 11, 2006.

Diagnosing DVT Diagnosis begins by confirming that you have risk factors for DVT Your doctor will ask about your general health, previous illnesses, including past episodes of DVT, the medicines you are taking, and your recent activities He or she will conduct a physical examination If DVT is suspected, additional tests will be needed to confirm the diagnosis

Treating DVT Treatment of DVT can help reduce complications such as PE The main goals in treating DVT are to: Stop the clot from getting larger Reduce the chance of developing another clot Reduce the risk of the clot breaking off in your vein and moving to your lungs

Treating DVT Drugs6 Practical measures8 Anticoagulants (blood thinners) Thrombolytic agents (drugs used to dissolve blood clots) Aspirin (treatment with aspirin alone may not be an effective form of prophylaxis) Practical measures8 Elevate the affected leg whenever possible Apply heat to relieve pain and reduce swelling Wear compression bandages or support hose Avoid long periods of immobility 6/Geerts.Chest. 2004/p3435/C1/L40 8/Ramzi.Am Fam Phys.2004/P2841/ A10;P2843/C1/L21 6. Geerts et al. Chest. 2001;119(suppl):132S-175S. 8. Ramzi and Leeper. Am Fam Physician. 2004;69(12):2841-2848.

Protecting Against DVT If you are planning surgery or an extended hospital stay, ask your doctor what you can do to reduce your risk of DVT Get out of bed and move around as soon as possible Take medicines to reduce the risk of DVT blood clots after illness or surgery as directed by your doctor

Summary DVT is a blood clot that forms in a vein deep in the body The clot or part of it may break off and travel to the lung Certain conditions may increase your risk for deep vein clots The more risk factors a person has, the greater the chances may be of developing DVT Anyone experiencing any DVT or PE symptoms should call for assistance and go to a hospital immediately

Share your concerns about DVT with your doctor Summary If your mobility is restricted for an extended period of time due to illness, surgery, or hospitalization, ask your doctor about protective treatment Only about half of the people with deep vein clots have symptoms The main goals in treating DVT are to stop the clot from getting larger, to decrease your chance of having another clot, and to reduce the risk of a clot breaking off in your vein and moving to your lungs Medicines are used to treat and/or help reduce the risk of DVT Share your concerns about DVT with your doctor

Remember… DVT doesn't have to happen to you — you and your doctor can protect against them If you develop a DVT blood clot, it can be treated Knowing your risks for DVT blood clots is the first step in protecting against them

For Additional Information on DVT: Visit: American Heart Association (AHA) www.americanheart.org American Obesity Association (AOA) www.obesity.org Coalition to Prevent DVT www.preventdvt.org National Heart Lung and Blood Institute (NHLBI) www.nhlbi.nih.gov DVT.NET www.dvt.net

References: 1. Gerotziafas GT, Samama MM. Prophylaxis of venous thromboembolism in medical patients. Curr Opin Pulm Med. 2004;10:356-365. 2. Heit JA, Cohen AT, Anderson FA, et al, on behalf of the VTE Impact Assessment Group. Estimated annual number of incident and recurrent, non-fatal and fatal venous thromboembolism (VTE) events in the US. Poster #68. Presented at: 47th Annual Meeting and Exposition, American Society of Hematology; December 10-13, 2005; Atlanta, Ga. 3. Thom T, Haase N, Rosamond W, et al. Heart disease and stroke statistics–2006 Update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2006;113:85-151. 4. Caprini JA, Arcelus JI. State-of-the-art venous thromboembolism prophylaxis. Scope Phlebol Lymphol. 2001;8:228-240. 5. American Public Health Association. Deep-vein thrombosis: advancing awareness to protect patient lives. Presented at: Public Health Leadership Conference on Deep-Vein Thrombosis: February 26, 2003: Washington, DC. 6. Geerts WH, Heit JA, Clagett GP, et al. Prevention of venous thromboembolism: Sixth ACCP Consensus Conference on Antithrombotic Therapy. Chest. 2001;119(suppl)132S-175S. 7. National Heart, Lung, and Blood Institute. Diseases and conditions index. Available at http://www.nhlbi.nih.gov/ health/dci/diseases/pe/pe_all.html. Accessed Sept. 7, 2006. 8. Ramzi DW, Leeper KV. DVT and pulmonary embolism: Part II: Treatment and prevention. Am Fam Physician. 2004; 69(12):2841-2848. US.ENO.00.00.00 ©2006 sanofi-aventis U.S. LLC