Marja K Puurunen1, Philimon N Gona2, Martin G Larson3, Joanne M Murabito4, Jared W Magnani5, Christopher J O'Donnell6. 1. Framingham Heart Study of Boston University School of Medicine and NHLBI, Framingham, MA, USA. 2. University of Massachusetts Boston, Boston, MA, USA. 3. Framingham Heart Study of Boston University School of Medicine and NHLBI, Framingham, MA, USA; Department of Mathematics and Statistics, Boston University, Boston, MA, USA; Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA. 4. Framingham Heart Study of Boston University School of Medicine and NHLBI, Framingham, MA, USA; Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston, MA, USA. 5. Framingham Heart Study of Boston University School of Medicine and NHLBI, Framingham, MA, USA; Section of Cardiovascular Medicine, Department of Medicine, Boston University School of Medicine, Boston, MA, USA. 6. Framingham Heart Study of Boston University School of Medicine and NHLBI, Framingham, MA, USA; NHLBI Division of Intramural Research, Bethesda, MD, USA; Cardiology Section, Department of Medicine, Boston Veteran's Administration Healthcare, Boston, MA, USA. Electronic address: Christopher.odonnell@va.gov.
Abstract
BACKGROUND: Reports of the crude incidence of venous thromboembolism (VTE) in Western countries vary widely. Data regarding risk factors, incidence and recurrence of VTE from deeply-phenotyped community-based cohort studies are needed. OBJECTIVES: To study the incidence, associated mortality, and predisposing factors of VTE in the prospective, longitudinal community-based Framingham Heart Study. PATIENTS/ METHODS: The study sample consisted of the Framingham Heart Study Original, Offspring, Third Generation, and Omni cohorts (N=9754). Incidence rates (IR) were standardized to the 2000 US population. Cox proportional hazards regression models were used to study risk factor associations. RESULTS: During 1995-2014 (total follow-up time 104,091 person-years [median 9.8 (range 0-20) years]), 297 incident VTE events were observed. Age-adjusted IR of VTE was 20.3/10,000 (95% CI 17.9-22.6). Of the events 120 (40%) were pulmonary embolism (PE) and 177 (60%) were deep venous thrombosis (DVT); 29% were unprovoked, 40% provoked, and 31% cancer-related. Cancer-related VTE was associated with high mortality at 30days (24.2%), 1year (66.3%), and 5years (75.6%). In multivariable models, age and obesity, but no other traditional cardiovascular risk factors, were significantly associated with VTE (hazard ratio [HR] per 10-year increase in age 1.69, 95% CI 1.48-1.92; HR for obesity (BMI≥30kg/m(2)) 1.88, 95% CI 1.44-2.45). CONCLUSIONS: We provide data on the epidemiology of VTE. VTE is associated with significant mortality, and prognosis after cancer-related VTE is particularly poor. Traditional cardiovascular risk factors beyond age and obesity are not associated with VTE. Published by Elsevier Ltd.
BACKGROUND: Reports of the crude incidence of venous thromboembolism (VTE) in Western countries vary widely. Data regarding risk factors, incidence and recurrence of VTE from deeply-phenotyped community-based cohort studies are needed. OBJECTIVES: To study the incidence, associated mortality, and predisposing factors of VTE in the prospective, longitudinal community-based Framingham Heart Study. PATIENTS/ METHODS: The study sample consisted of the Framingham Heart Study Original, Offspring, Third Generation, and Omni cohorts (N=9754). Incidence rates (IR) were standardized to the 2000 US population. Cox proportional hazards regression models were used to study risk factor associations. RESULTS: During 1995-2014 (total follow-up time 104,091 person-years [median 9.8 (range 0-20) years]), 297 incident VTE events were observed. Age-adjusted IR of VTE was 20.3/10,000 (95% CI 17.9-22.6). Of the events 120 (40%) were pulmonary embolism (PE) and 177 (60%) were deep venous thrombosis (DVT); 29% were unprovoked, 40% provoked, and 31% cancer-related. Cancer-related VTE was associated with high mortality at 30days (24.2%), 1year (66.3%), and 5years (75.6%). In multivariable models, age and obesity, but no other traditional cardiovascular risk factors, were significantly associated with VTE (hazard ratio [HR] per 10-year increase in age 1.69, 95% CI 1.48-1.92; HR for obesity (BMI≥30kg/m(2)) 1.88, 95% CI 1.44-2.45). CONCLUSIONS: We provide data on the epidemiology of VTE. VTE is associated with significant mortality, and prognosis after cancer-related VTE is particularly poor. Traditional cardiovascular risk factors beyond age and obesity are not associated with VTE. Published by Elsevier Ltd.
Authors: Greta Lee Splansky; Diane Corey; Qiong Yang; Larry D Atwood; L Adrienne Cupples; Emelia J Benjamin; Ralph B D'Agostino; Caroline S Fox; Martin G Larson; Joanne M Murabito; Christopher J O'Donnell; Ramachandran S Vasan; Philip A Wolf; Daniel Levy Journal: Am J Epidemiol Date: 2007-03-19 Impact factor: 4.897
Authors: Keattiyoat Wattanakit; Pamela L Lutsey; Elizabeth J Bell; Heather Gornik; Mary Cushman; Susan R Heckbert; Wayne D Rosamond; Aaron R Folsom Journal: Thromb Haemost Date: 2012-07-10 Impact factor: 5.249
Authors: Kathryn L Lunetta; Ralph B D'Agostino; David Karasik; Emelia J Benjamin; Chao-Yu Guo; Raju Govindaraju; Douglas P Kiel; Margaret Kelly-Hayes; Joseph M Massaro; Michael J Pencina; Sudha Seshadri; Joanne M Murabito Journal: BMC Med Genet Date: 2007-09-19 Impact factor: 2.103
Authors: Thomas L Ortel; Katie Arnold; Michele Beckman; Audrey Brown; Nimia Reyes; Ibrahim Saber; Ryan Schulteis; Bhavana Pendurthi Singh; Andrea Sitlinger; Elizabeth H Thames Journal: Appl Clin Inform Date: 2019-07-31 Impact factor: 2.342
Authors: Marja K Puurunen; Shih-Jen Hwang; Chris J O'Donnell; Geoffrey Tofler; Andrew D Johnson Journal: Thromb Res Date: 2017-01-25 Impact factor: 3.944
Authors: John B Harringa; Rebecca L Bracken; Scott K Nagle; Mark L Schiebler; Brian W Patterson; James E Svenson; Michael D Repplinger Journal: Am J Emerg Med Date: 2016-09-30 Impact factor: 2.469
Authors: Darae Ko; Sarah R Preis; Andrew D Johnson; Ramachandran S Vasan; Emelia J Benjamin; Naomi M Hamburg; Gary F Mitchell Journal: Thromb Res Date: 2021-06-19 Impact factor: 10.407