Dataset Information

Cardiovascular Risk Factors Associated With Venous Thromboembolism.

ABSTRACT:

Importance

It is uncertain to what extent established cardiovascular risk factors are associated with venous thromboembolism (VTE).

Objective

To estimate the associations of major cardiovascular risk factors with VTE, ie, deep vein thrombosis and pulmonary embolism.

Design, setting, and participants

This study included individual participant data mostly from essentially population-based cohort studies from the Emerging Risk Factors Collaboration (ERFC; 731 728 participants; 75 cohorts; years of baseline surveys, February 1960 to June 2008; latest date of follow-up, December 2015) and the UK Biobank (421 537 participants; years of baseline surveys, March 2006 to September 2010; latest date of follow-up, February 2016). Participants without cardiovascular disease at baseline were included. Data were analyzed from June 2017 to September 2018.

Exposures

A panel of several established cardiovascular risk factors.

Main outcomes and measures

Hazard ratios (HRs) per 1-SD higher usual risk factor levels (or presence/absence). Incident fatal outcomes in ERFC (VTE, 1041; coronary heart disease [CHD], 25 131) and incident fatal/nonfatal outcomes in UK Biobank (VTE, 2321; CHD, 3385). Hazard ratios were adjusted for age, sex, smoking status, diabetes, and body mass index (BMI).

Results

Of the 731 728 participants from the ERFC, 403 396 (55.1%) were female, and the mean (SD) age at the time of the survey was 51.9 (9.0) years; of the 421 537 participants from the UK Biobank, 233 699 (55.4%) were female, and the mean (SD) age at the time of the survey was 56.4 (8.1) years. Risk factors for VTE included older age (ERFC: HR per decade, 2.67; 95% CI, 2.45-2.91; UK Biobank: HR, 1.81; 95% CI, 1.71-1.92), current smoking (ERFC: HR, 1.38; 95% CI, 1.20-1.58; UK Biobank: HR, 1.23; 95% CI, 1.08-1.40), and BMI (ERFC: HR per 1-SD higher BMI, 1.43; 95% CI, 1.35-1.50; UK Biobank: HR, 1.37; 95% CI, 1.32-1.41). For these factors, there were similar HRs for pulmonary embolism and deep vein thrombosis in UK Biobank (except adiposity was more strongly associated with pulmonary embolism) and similar HRs for unprovoked vs provoked VTE. Apart from adiposity, these risk factors were less strongly associated with VTE than CHD. There were inconsistent associations of VTEs with diabetes and blood pressure across ERFC and UK Biobank, and there was limited ability to study lipid and inflammation markers.

Conclusions and relevance

Older age, smoking, and adiposity were consistently associated with higher VTE risk.

SUBMITTER: Gregson J

PROVIDER: S-EPMC6386140 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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Publications

Cardiovascular Risk Factors Associated With Venous Thromboembolism.

Gregson John J Kaptoge Stephen S Bolton Thomas T Pennells Lisa L Willeit Peter P Burgess Stephen S Bell Steven S Sweeting Michael M Rimm Eric B EB Kabrhel Christopher C Zöller Bengt B Assmann Gerd G Gudnason Vilmundur V Folsom Aaron R AR Arndt Volker V Fletcher Astrid A Norman Paul E PE Nordestgaard Børge G BG Kitamura Akihiko A Mahmoodi Bakhtawar K BK Whincup Peter H PH Knuiman Matthew M Salomaa Veikko V Meisinger Christa C Koenig Wolfgang W Kavousi Maryam M Völzke Henry H Cooper Jackie A JA Ninomiya Toshiharu T Casiglia Edoardo E Rodriguez Beatriz B Ben-Shlomo Yoav Y Després Jean-Pierre JP Simons Leon L Barrett-Connor Elizabeth E Björkelund Cecilia C Notdurfter Marlene M Kromhout Daan D Price Jackie J Sutherland Susan E SE Sundström Johan J Kauhanen Jussi J Gallacher John J Beulens Joline W J JWJ Dankner Rachel R Cooper Cyrus C Giampaoli Simona S Deen Jason F JF Gómez de la Cámara Agustín A Kuller Lewis H LH Rosengren Annika A Svensson Peter J PJ Nagel Dorothea D Crespo Carlos J CJ Brenner Hermann H Albertorio-Diaz Juan R JR Atkins Robert R Brunner Eric J EJ Shipley Martin M Njølstad Inger I Lawlor Deborah A DA van der Schouw Yvonne T YT Selmer Randi Marie RM Trevisan Maurizio M Verschuren W M Monique WMM Greenland Philip P Wassertheil-Smoller Sylvia S Lowe Gordon D O GDO Wood Angela M AM Butterworth Adam S AS Thompson Simon G SG Danesh John J Di Angelantonio Emanuele E Meade Tom T

JAMA cardiology 20190201 2

<h4>Importance</h4>It is uncertain to what extent established cardiovascular risk factors are associated with venous thromboembolism (VTE).<h4>Objective</h4>To estimate the associations of major cardiovascular risk factors with VTE, ie, deep vein thrombosis and pulmonary embolism.<h4>Design, setting, and participants</h4>This study included individual participant data mostly from essentially population-based cohort studies from the Emerging Risk Factors Collaboration (ERFC; 731 728 participants; ...[more]

PMID: 30649175

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Project description:ImportanceThe size of the risk of recurrent venous thromboembolism (VTE) after surgery in patients with a history of VTE is not well known.ObjectivesTo estimate the risk of and to identify the factors associated with recurrent VTE in patients undergoing surgery who have a history of VTE.Design, setting, and participantsThis population-based, follow-up cohort study includes patients with VTE who participated in the Multiple Environment and Genetic Assessment (MEGA) study. Original data were collected from March 1999 to April 2010. Data analysis began in June 1999 and ended in April 2010.ExposuresSurgery following a first VTE.Main outcomes and measurementsKaplan-Meier analyses were used to estimate cumulative incidences of recurrent VTE. Cox regression with a time-dependent covariate (surgery) was used to calculate the hazard ratio (HR) for developing recurrent VTE after surgery compared with no surgery.ResultsOverall, 3741 patients (mean [SD] age, 48.4 [12.8] years; 2020 [54.0%] women) with a history of VTE were included in the analysis, amounting to 18 899 person-years, with a median (interquartile range) follow-up of 5.7 (3.0-7.2) years. Of the 3741 patients, 580 (15.5%) underwent surgery and 601 (16.1%) developed a recurrent thrombotic event. The 1-month cumulative incidence of recurrent VTE for all surgery types was 2.1% (95% CI, 1.2%-3.6%), which increased to 3.3% (95% CI, 2.1%-5.1%) at 3 months and 4.6% (95% CI, 3.1%-6.6%) at 6 months. At 6 months, risk of recurrent VTE ranged from 2.3% to 9.3%, depending on surgery type. In addition to surgery type, factor V Leiden mutation (HR, 3.4; 95% CI, 1.6-7.4) and male sex (HR, 2.7; 95% CI, 1.3-5.8) were associated with increased risk of recurrent VTE.Conclusions and relevanceSurgery was associated with an increased risk of recurrent VTE in patients with a history of VTE; risk remained high for up to 6 months after the procedure. This study suggests that high-risk individuals may be identified based on surgery type, sex, and the presence of factor V Leiden mutation. These findings stress the need for revision of the current thromboprophylactic approach to prevent recurrence in these patients.

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Dataset Information

Cardiovascular Risk Factors Associated With Venous Thromboembolism.

Importance

Objective

Design, setting, and participants

Exposures

Main outcomes and measures

Results

Conclusions and relevance

Publications

Cardiovascular Risk Factors Associated With Venous Thromboembolism.

Similar Datasets

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