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Zu J, Yang T. Exploring Risk Factors for Lower Extremity Deep Vein Thrombosis Patients with Co-existing Pulmonary Embolism Based on Multiple Logistic Regression Model. Clin Appl Thromb Hemost 2024; 30:10760296241258230. [PMID: 38785063 PMCID: PMC11131404 DOI: 10.1177/10760296241258230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 05/07/2024] [Accepted: 05/14/2024] [Indexed: 05/25/2024] Open
Abstract
Valuable data on deep vein thrombosis (DVT) patients with coexisting pulmonary embolism (PE) is scarce. This study aimed to identify risk factors associated with these patients and develop logistic regression models to select high-risk DVT patients with coexisting PE. We retrospectively collected data on 150 DVT patients between July 15, 2022, and June 15, 2023, dividing them into groups based on the presence of coexisting PE. Univariate and multivariate logistic regression analyses were performed to identify significant risk factors and construct predictive models. Discrimination and calibration statistics evaluated the validation and accuracy of the developed models. Of the 130 patients analyzed, 40 (30.77%) had coexisting PE. Univariate analysis revealed four significant predictors of DVT patients with coexisting PE: sex (OR 3.83, 95% CI: [1.76; 8.59], P = 0.001), body mass index (BMI) (OR 1.50, 95% CI: [1.28; 1.75], P < 0.001), chronic disease (OR 5.15, 95% CI: [2.32; 11.8], P < 0.001), and high-density lipoprotein (HDL) (OR 0.03, 95% CI: [0.01; 0.20], P < 0.001). Additionally, BMI > 24 kg/m2 (OR 9.70, 95% CI: [2.70; 67.5], P < 0.001) and BMI > 28 kg/m2 (OR 4.80, 95% CI: [2.15; 11.0], P < 0.001) were associated with concurrent PE. Three multiple regression models were constructed, with areas under the receiver-operating characteristic curves of 0.925 (95% CI: [0.882; 0.968]), 0.908 (95% CI: [0.859; 0.957]), and 0.890 (95% CI: [0.836; 0.944]), respectively. Sex, BMI, chronic disease, and HDL levels are significant predictors of DVT patients with coexisting PE.
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Affiliation(s)
- Jiahong Zu
- School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Tao Yang
- General Surgery Department, Third Hospital of Shanxi Medical University, Taiyuan, China
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2
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Lind MM, Johansson M, Själander A, Johansson L. Incidence and risk factors of venous thromboembolism in men and women. Thromb Res 2022; 214:82-86. [DOI: 10.1016/j.thromres.2022.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 04/07/2022] [Accepted: 04/20/2022] [Indexed: 10/18/2022]
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3
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Adamo A, Spiezia L, Dalla VF, Avruscio G, Simioni P. Potential Association between Distal Deep Vein Thrombosis and Asymptomatic Atherosclerosis. TH OPEN 2022; 5:e585-e590. [PMID: 34984318 PMCID: PMC8718265 DOI: 10.1055/s-0041-1741076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 10/11/2021] [Indexed: 01/10/2023] Open
Abstract
Background
Several studies have previously reported an association between idiopathic proximal deep vein thrombosis (DVT) and atherosclerosis, but whether spontaneous distal DVT is associated with asymptomatic atherosclerosis is still unknown.
Methods
Ultrasonography of the carotid arteries was done for plaque detection and intima-media thickness (IMT) evaluation, and the ankle-brachial index (ABI) in 116 patients with spontaneous DVT and without symptomatic atherosclerosis. Fifty-seven patients (M/F 19/38, age range 54–78 years) had distal DVT and 59 (M/F 24/35, age range 51–73 years) had proximal DVT. A group of 57 (M/F 21/36, age range 64–70 years) matched subjects acted as controls.
Results
No significant difference was found in carotid plaques between patients with distal or proximal DVT versus controls (
p
> 0.05 in all comparisons). Carotid IMT (mean ± SD) was significantly increased in patients with distal (1.00 ± 0.20 mm) and proximal (0.98 ± 0.16 mm) DVT versus controls (0.88 ± 0.15 mm,
p
<0.01 in both comparisons). An ABI £ 0.9 was found in 3/57 (5.3%) and 5/59 (8.5%) patients with distal and proximal DVT, respectively versus no controls with abnormal ABI.
Conclusion
Our results revealed that there may be an association between spontaneous distal DVT and asymptomatic atherosclerosis, and confirmed the known association between idiopathic proximal DVT and asymptomatic atherosclerosis. Larger studies are needed to confirm our results and to evaluate their clinical implications.
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Affiliation(s)
- Angelo Adamo
- Department of Medicine, Thrombotic and Hemorrhagic Diseases Unit, Padova University Hospital, Padova, Italy
| | - Luca Spiezia
- Department of Medicine, Thrombotic and Hemorrhagic Diseases Unit, Padova University Hospital, Padova, Italy
| | - Valle Fabio Dalla
- Department of Medicine, Thrombotic and Hemorrhagic Diseases Unit, Padova University Hospital, Padova, Italy
| | - Giampiero Avruscio
- Department of Cardiac, Angiology Unit, Thoracic and Vascular Sciences, Padova University Hospital, Padova, Italy
| | - Paolo Simioni
- Department of Medicine, Thrombotic and Hemorrhagic Diseases Unit, Padova University Hospital, Padova, Italy
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4
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Quintero M, Tasic L, Annichino-Bizzacchi J. Thrombosis: Current knowledge based on metabolomics by nuclear magnetic resonance (NMR) spectroscopy and mass spectrometry (MS). THROMBOSIS UPDATE 2020. [DOI: 10.1016/j.tru.2020.100011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
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5
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Hounkpe BW, Benatti RDO, Carvalho BDS, De Paula EV. Identification of common and divergent gene expression signatures in patients with venous and arterial thrombosis using data from public repositories. PLoS One 2020; 15:e0235501. [PMID: 32780732 PMCID: PMC7418995 DOI: 10.1371/journal.pone.0235501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 06/17/2020] [Indexed: 12/31/2022] Open
Abstract
Cardiovascular disease (CVD) and venous thromboembolism (VTE) figure among the main causes of morbidity and mortality in modern societies. Although associated with distinct pathogenic mechanisms, epidemiological, experimental and clinical trial data suggest that the mechanisms responsible for arterial and venous thrombosis are at least partially overlapped. Herein we aimed to explore shared and discordant pathways involved in the pathogenesis of VTE and CVD at the transcriptomic level and to validate the results in independent cohorts. Five public datasets of gene expression data from VTE and CVD (myocardial infarction, peripheral arterial occlusive disease and stroke) patients were analyzed using an integrative bioinformatic strategy. A machine/statistical learning method was used to derive classifiers for the discrimination of VTE and CVD, and tested in independent datasets. Two sets of genes that were commonly (n = 472) or divergently (n = 124) expressed in CVD and VTE were identified. Genes and pathways associated with innate immune function were over-represented in both conditions, along with pathways associated with complement and hemostasis. Pathways associated with neutrophil activation and with IL-1 signaling were also enriched in CVD compared to VTE. The gene expression signature of VTE more closely resembled the pattern of cardioembolic stroke than the patterns of acute myocardial infarction, ischemic stroke and peripheral arterial occlusive disease. Classifiers derived from these gene lists accurately discriminated patients with VTE and CVD from independent cohorts. In conclusion, our results add a new set of data at the transcriptomic level for future studies between arterial and venous thrombosis.
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Affiliation(s)
| | | | - Benilton de Sá Carvalho
- Department of Statistics, Institute of Mathematics, Statistics and Scientific Computing, University of Campinas, Campinas, SP, Brazil
| | - Erich Vinicius De Paula
- School of Medical Sciences, University of Campinas, Campinas, SP, Brazil
- Hematology and Hemotherapy Center, University of Campinas, Campinas, SP, Brazil
- * E-mail:
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6
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Huang HK, Kor CT, Chen CP, Chen HT, Yang PT, Tsai CD, Huang CH. Increased Risk of Venous Thromboembolism in Women with Uterine Leiomyoma: A Nationwide, Population-Based Case-Control Study. ACTA CARDIOLOGICA SINICA 2018; 34:66-76. [PMID: 29375226 DOI: 10.6515/acs.201801_34(1).20170901b] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background Venous thromboembolism (VTE) is a sex-specific disease that has different presentations between men and women. Women with uterine leiomyoma can present with VTE without exhibiting the traditional risk factors. We investigated the relationship between a history of uterine leiomyoma and the risk of VTE using the National Health Insurance Research Database (NHIRD). Methods We conducted a retrospective, nationwide, population-based case-control study using the NHIRD. We identified 2,282 patients with diagnosed VTE and 392,635 subjects without VTE from 2000 to 2013. After development of an age and index diagnosis year frequency-matched model and propensity score-matched model, 2 models with a case-to-control ratio of 1 to 4 were established. Using the diagnosis of uterine leiomyoma as the exposure factor, conditional logistic regression was performed to examine the association between uterine leiomyoma and VTE. Multiple logistic regression analysis was used to investigate the joint effect of uterine leiomyoma and comorbid diseases on the risk of VTE. Results A strong association was observed between uterine leiomyoma and VTE in the overall patient model, frequency-matched model and propensity score-matched model [p < 0.0001, odds ratio (OR): 1.547; p = 0.0005, OR: 1.486; p = 0.0405, OR: 1.26, respectively]. In the subgroup analyses, women with uterine leiomyoma who were ≥ 45 years old were less likely to experience VTE, but women with uterine leiomyoma and anemia, cancer, coronary artery disease or heart failure were more likely to experience VTE. Conclusions Women with uterine leiomyomas have an increased risk of developing VTE, especially during reproductive periods or in the presence of specific diseases.
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Affiliation(s)
| | - Chew-Teng Kor
- Internal Medicine Research Center, Changhua Christian Hospital
| | - Ching-Pei Chen
- Division of Cardiology, Department of Internal Medicine.,Department of Beauty Science and Graduate Institute of Beauty Science Technology, Chienkuo Technology University, Changhua
| | - Hung-Te Chen
- Division of Cardiology, Department of Internal Medicine
| | - Po-Ta Yang
- Division of Cardiology, Department of Internal Medicine
| | - Chen-Dao Tsai
- Division of Cardiology, Department of Internal Medicine
| | - Ching-Hui Huang
- Division of Cardiology, Department of Internal Medicine.,Department of Beauty Science and Graduate Institute of Beauty Science Technology, Chienkuo Technology University, Changhua.,School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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7
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Increased risk and severity of unprovoked venous thromboembolism with clustering cardiovascular risk factors for atherosclerosis: Results of the REMOTEV registry. Int J Cardiol 2017; 252:169-174. [PMID: 29169908 DOI: 10.1016/j.ijcard.2017.11.055] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 11/01/2017] [Accepted: 11/16/2017] [Indexed: 01/23/2023]
Abstract
BACKGROUND The role of cardiovascular risk factors (CVRF) for atherosclerosis in venous thromboembolic disease (VTE) is controversial. The aim of this study was to evaluate the impact of CVRF and their cumulative effects on the occurrence of unprovoked VTE, severity, recurrence and survival. METHODS AND RESULTS This is a prospective cohort from the REMOTEV registry including all consecutively hospitalized patients for acute symptomatic VTE. From November 2013 to December 2016, 515 patients with 6months follow-up (FU) were selected for the analysis. Events were classified as unprovoked or provoked VTE. In univariate analysis, hypertension (OR 1.44, [95% CI 1.01-2.06]), diabetes (OR 2.07, [95% CI: 1.25-3.55]) and age (OR 1.94, [95% CI: 1.31-2.88]) were significantly associated with the risk of unprovoked VTE. After adjustment, diabetes (OR 1.82, [95% CI: 1.07-3.18]) and age (OR 1.79, [95% CI: 1.15-2.8]) remained associated with the risk of unprovoked VTE. The proportion of unprovoked VTE increased significantly with the number of CVRF adjusted for thrombophilia (1 CVRF: OR 3 [95% CI: 1.44-6.52]) 2 CVRF: OR 4.33 [95% CI: 2.07-9.49] and ≥3 CVRF: OR 4.58 [95% CI: 2.27-9.7]). The severity of pulmonary embolism was significantly associated with CVRF clustering. There were more VTE recurrences and deaths during the 6months of FU with cumulative CVRF. CONCLUSION The risks of unprovoked VTE and PE severity are associated with clustering CVRF. The role of cumulative CVRF predominates rather than the specific burden of each of the CVRF in the risk of VTE occurrence.
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8
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Prandoni P, Ciammaichella M, Mumoli N, Zanatta N, Visonà A, Avruscio G, Camporese G, Bucherini E, Bova C, Imberti D, Benedetti R, Rossetto V, Noventa F, Milan M. An association between residual vein thrombosis and subclinical atherosclerosis: Cross-sectional study. Thromb Res 2017; 157:16-19. [PMID: 28679112 DOI: 10.1016/j.thromres.2017.06.036] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 06/25/2017] [Accepted: 06/27/2017] [Indexed: 01/03/2023]
Abstract
BACKGROUND The association between venous and arterial thrombotic disorders is still unclear. We assessed the association between residual vein thrombosis (RVT) and subclinical atherosclerosis in a cohort of patients with unprovoked (or associated with weak risk factors) proximal deep-vein thrombosis (DVT). METHODS In a multicenter cross-sectional study, consecutive patients over 40years free from atherosclerotic disorders received the ultrasound assessment of the leg vein system and that of carotid arteries approximately three months after an episode of proximal DVT. In each center the evaluation was done by two independent assessors. The presence of RVT was defined as the incompressibility of at least 4mm in either the popliteal or the common femoral vein, and that of subclinical atherosclerosis as the presence of increased (>0.9mm) intima-media tickness (IMT) and/or carotid plaques. RESULTS Out of 252 patients (mean age, 67; males, 53%; unprovoked, 77%), the presence of RVT was found in 139 (55.2%). An increased IMT was shown in 76 (54.7%) patients with and in 35 (31.0%) without RVT (p<0.001). At least one carotid plaque was found in 80 (57.6%) patients with and in 36 (31.9%) without RVT (p<0.001). After adjusting for the baseline characteristics, the odds ratio of subclinical atherosclerosis (increased IMT and/or carotid plaques) was 2.8 (95% CI, 1.6 to 4.7). CONCLUSION The ultrasound detection of RVT after an episode of proximal DVT that is either unprovoked or triggered by weak risk factors is associated with a higher prevalence of subclinical atherosclerosis. These findings may have implications for patient prognosis.
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Affiliation(s)
- Paolo Prandoni
- Department of Cardiovascular Sciences, Vascular Medicine Unit, University of Padua, Italy.
| | | | - Nicola Mumoli
- Department of Internal Medicine, Civic Hospital of Livorno, Italy
| | - Nello Zanatta
- Division of General Medicine, Presidio Hospital of Conegliano Veneto, Italy
| | - Adriana Visonà
- Department of Angiology, S. Giacomo Apostolo Hospital, Castelfranco, Italy
| | - Giampiero Avruscio
- Department of Cardiovascular Sciences, Angiology Unit, University of Padua, Italy
| | - Giuseppe Camporese
- Department of Cardiovascular Sciences, Angiology Unit, University of Padua, Italy
| | | | - Carlo Bova
- Division of Internal Medicine, Civic Hospital of Cosenza, Italy
| | - Davide Imberti
- Haemostasis and Thrombosis Center, Department of Internal Medicine, Hospital of Piacenza, Italy
| | - Raffaella Benedetti
- Haemostasis and Thrombosis Center, Department of Internal Medicine, Hospital of Piacenza, Italy
| | - Valeria Rossetto
- Internal Medicine, Civic Hospital of San Daniele Del Friuli, Italy
| | - Franco Noventa
- Department of Cardiovascular Sciences, Vascular Medicine Unit, University of Padua, Italy
| | - Marta Milan
- Department of Cardiovascular Sciences, Vascular Medicine Unit, University of Padua, Italy
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9
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Lind C, Småbrekke B, Rinde LB, Hindberg K, Mathiesen EB, Johnsen SH, Arntzen KA, Njølstad I, Lijfering W, Brækkan SK, Hansen JB. Impact of Venous Thromboembolism on the Formation and Progression of Carotid Atherosclerosis: The Tromsø Study. TH OPEN 2017; 1:e66-e72. [PMID: 31249912 PMCID: PMC6524840 DOI: 10.1055/s-0037-1603983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Venous thromboembolism (VTE) is associated with increased risk of arterial cardiovascular diseases (CVD), and development of atherosclerosis secondary to VTE may be an intermediate between VTE and CVD. Therefore, we aimed to investigate whether incident VTE was associated with subsequent carotid atherosclerosis formation and progression in a population-based observational study. Subjects attending two or more ultrasound examinations of the right carotid artery, with measurement of total plaque area (TPA), in the Tromsø Study in 1994–1995, 2001–2002, and/or 2007–2008 were eligible. We identified 150 subjects diagnosed with first-lifetime VTE between the initial and follow-up visit, and randomly selected 600 age- and sex-matched subjects without VTE between the visits. Subjects with VTE and carotid plaque(s) at the first visit had 4.1 mm
2
(β: 4.13, 95% CI: −1.72 to 9.98) larger change in TPA between the first and second visit compared with subjects without VTE after adjustment for change in high-sensitivity C-reactive protein (hs-CRP) and traditional atherosclerotic risk factors. The association remained after restricting the analyses to VTE events diagnosed in the first half of the time interval between the carotid ultrasounds (β: 4.02, 95% CI: −3.66 to 11.70), supporting that the change in TPA occurred subsequent to the VTE. No association was found between VTE and novel carotid plaque formation. In conclusion, we found a possible association between VTE and atherosclerosis progression in those with already established carotid plaques, but not between VTE and novel plaque formation. The association between VTE and carotid plaque progression was not mediated by low-grade inflammation assessed by hs-CRP.
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Affiliation(s)
- Caroline Lind
- K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway.,Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Birgit Småbrekke
- K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Ludvig Balteskard Rinde
- K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Kristian Hindberg
- K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Ellisiv Bøgeberg Mathiesen
- K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway.,Brain and Circulation Research Group, Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway.,Department of Neurology and Clinical Neurophysiology, University Hospital of North Norway, Tromsø, Norway
| | - Stein Harald Johnsen
- Brain and Circulation Research Group, Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway.,Department of Neurology and Clinical Neurophysiology, University Hospital of North Norway, Tromsø, Norway
| | - Kjell Arne Arntzen
- Brain and Circulation Research Group, Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway.,Department of Neurology and Clinical Neurophysiology, University Hospital of North Norway, Tromsø, Norway
| | - Inger Njølstad
- K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway.,Epidemiology of Chronic Diseases Research Group, Department of Community Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Willem Lijfering
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Sigrid Kufaas Brækkan
- K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway.,Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
| | - John-Bjarne Hansen
- K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway.,Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
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10
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Chiu CC, Chen YT, Hsu CY, Chang CC, Huang CC, Leu HB, Li SY, Kuo SC, Huang PH, Chen JW, Lin SJ. Association between previous history of gout attack and risk of deep vein thrombosis - a nationwide population-based cohort study. Sci Rep 2016; 6:26541. [PMID: 27231197 PMCID: PMC4882589 DOI: 10.1038/srep26541] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 04/25/2016] [Indexed: 12/16/2022] Open
Abstract
Although the association of hyperuricemia and cardiovascular diseases is well established by previous research studies, the relationship between gout and deep vein thrombosis (DVT) remains unclear. We conducted a nationwide longitudinal cohort study to investigate the relationship between gout and DVT. We used the Taiwan National Health Insurance Research Database to identify patients with gout diagnosed in Taiwan during 2000–2011, and we followed up these patients to determine the incidence of DVT among them. The association between gout and DVT was analyzed by cox proportional hazard model. The study cohort included 35,959 patients with history of gout attack and 35,959 matched controls without gout attack. During the median follow-up of 7.5 ± 3.6 years, the incidence rate of DVT was significantly higher in patients with gout than that in control group (13.48 versus 9.77 per 104 person-years, p < 0.001). Kaplan-Meier analysis revealed a tendency toward DVT development in gout patients (log rank test, p < 0.001). In a Cox model, patients with gout were found to have a 1.38-fold (95% confidence interval [CI], 1.18 to 1.62, p < 0.001) higher risk of developing DVT. Hyperuricemia with gout attack could be a possible risk predictor for DVT, but these findings need to be confirmed in future clinical and experimental studies.
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Affiliation(s)
- Chun-Chih Chiu
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital,Taipei, Taiwan.,Cardiovascular Research Center, National Yang-Ming University,Taipei, Taiwan
| | - Yung-Tai Chen
- Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei,Taiwan.,Department of Medicine, Taipei City Hospital Heping Fuyou Branch, Taipei, Taiwan.,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chien-Yi Hsu
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital,Taipei, Taiwan.,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Medicine, Yuli branch, Taipei Veterans General Hospital, Hualien, Taiwan
| | - Chun-Chin Chang
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital,Taipei, Taiwan.,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chin-Chou Huang
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital,Taipei, Taiwan.,Cardiovascular Research Center, National Yang-Ming University,Taipei, Taiwan.,Department of Education, Taipei Veterans General Hospital,Taipei, Taiwan
| | - Hsin-Bang Leu
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital,Taipei, Taiwan.,Cardiovascular Research Center, National Yang-Ming University,Taipei, Taiwan.,Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Szu-Yuan Li
- Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei,Taiwan.,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Shu-Chen Kuo
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.,National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Miaoli County, Taiwan
| | - Po-Hsun Huang
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital,Taipei, Taiwan.,Cardiovascular Research Center, National Yang-Ming University,Taipei, Taiwan.,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Jaw-Wen Chen
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital,Taipei, Taiwan.,Cardiovascular Research Center, National Yang-Ming University,Taipei, Taiwan.,Department of Medical Research, Taipei Veterans General Hospital,Taipei, Taiwan.,Institute of Pharmacology, National Yang-Ming University,Taipei, Taiwan
| | - Shing-Jong Lin
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital,Taipei, Taiwan.,Cardiovascular Research Center, National Yang-Ming University,Taipei, Taiwan.,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Medical Research, Taipei Veterans General Hospital,Taipei, Taiwan.,Taipei Medical University, Taipei, Taiwan
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11
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Prandoni P. Venous and Arterial Thrombosis: Is There a Link? ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2016; 906:273-283. [PMID: 27628000 DOI: 10.1007/5584_2016_121] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
An increasing body of evidence suggests the likelihood of a link between venous and arterial thrombosis. The two vascular complications share several risk factors, such as age, obesity, smoking, diabetes mellitus, blood hypertension, hypertriglyceridemia, and metabolic syndrome. Moreover, there are many examples of conditions accounting for both venous and arterial thrombosis, such as the antiphospholipid antibody syndrome, hyperhomocysteinemia, malignancies, infections, and the use of hormonal treatment. Finally, several recent studies have consistently shown that patients with venous thromboembolism are at a higher risk of arterial thrombotic complications than matched control individuals. We, therefore, speculate the two vascular complications are simultaneously triggered by biological stimuli responsible for activating coagulation and inflammatory pathways in both the arterial and the venous system. Future studies are needed to clarify the nature of this association, to assess its extent, and to evaluate its implications for clinical practice.
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Affiliation(s)
- Paolo Prandoni
- Department of Cardiothoracic and Vascular Sciences, Vascular Medicine Unit, University Hospital of Padua, Via Giustiniani 2, 35128, Padua, Italy.
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12
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Giladi O, Steinberg DM, Peleg K, Tanne D, Givon A, Grossman E, Klein Y, Avigdori S, Greenberg G, Katz R, Shalev V, Salomon O. Head trauma is the major risk factor for cerebral sinus-vein thrombosis. Thromb Res 2015; 137:26-29. [PMID: 26653366 DOI: 10.1016/j.thromres.2015.11.035] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 10/13/2015] [Accepted: 11/23/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND Cerebral sinus vein thrombosis (CSVT) is a rare disease with significant neurological sequelae and high mortality rate. Incidence of CSVT diagnosis in the western world has increased despite the reduced occurrence of infections. AIM To identify risk factors that may explain the predisposition to site specific thrombosis. METHODS Ninety consecutive patients diagnosed with acute CSVT in tertiary hospital. As a control group we used the data extracted from the National Trauma Registry and Healthcare Services. RESULTS Trauma history up to one month prior to diagnosis of CVST was found in 13 (14%) patients. Six patients had skull fractures, the others had blunt trauma. The overall SMR was 941 (p<0.0001); the separate results for men and women were 1206 and 543, respectively. Infections confined to the head and neck in 7% of the cases and brain tumor were observed in 8%. At the time of CVST, 23 of 50 (46%) women had a hormonal risk factor. The SMR for OC use was 1.63 (p=0.0298). Prothrombotic polymorphisms were detected in 16 of 63 (25.4%) patients who were tested for factor V Leiden and prothrombin G20210A mutation (OR=3.47, p=0.002) in comparison to 49% in DVT patients (OR=9.95, p<0.0001). CONCLUSIONS Assessment for CVST in patients with recent trauma and headache even after intact head CT is required. The other risk factors, such as hormone related and prothrombotic polymorphisms, were not specific just for CVST and the latter play a lesser role in CVST than in DVT.
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Affiliation(s)
- Ornit Giladi
- Department of Internal Medicine "D", Sheba Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Israel
| | - David M Steinberg
- Department of Statistics and Operations Research, Faculty of Exact Sciences, Tel Aviv University, Israel
| | - Kobi Peleg
- National Center of Trauma and Emergency Medicine Research, Gertner Institute for Health Policy & Epidemiology Head, Israel; Disaster Medicine and School of Public Health, Tel-Aviv University, Israel
| | - David Tanne
- Stroke Center, Department of Neurology, Sheba Medical Center, Sackler Faculty of Medicine, Israel
| | - Adi Givon
- National Center of Trauma and Emergency Medicine Research, Gertner Institute for Health Policy & Epidemiology Head, Israel
| | - Ehud Grossman
- Department of Internal Medicine "D", Sheba Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Israel
| | - Yoram Klein
- Trauma Unit, Sheba Medical Center, Tel Hashomer, Israel
| | | | - Gahl Greenberg
- Diagnostic Imaging of Sheba Medical Center, Tel Hashomer, Israel
| | - Rachel Katz
- School of Public Health, Tel-Aviv University, Israel
| | - Varda Shalev
- School of Public Health, Tel-Aviv University, Israel
| | - Ophira Salomon
- The Institute of Thrombosis and Hemostasis, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel.
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