S Gaertner1, E-M Cordeanu2, C Mirea2, A-S Frantz2, C Auger3, P Bilbault4, P Ohlmann5, V Schini-Kerth3, D Stephan2. 1. Department of Vascular Medicine and Clinical Pharmacology, Strasbourg Regional University Hospital, France. Electronic address: sebastien.gaertner@chru-strasbourg.fr. 2. Department of Vascular Medicine and Clinical Pharmacology, Strasbourg Regional University Hospital, France. 3. Laboratoire de Biophotonique et Pharmacologie, UMR CNRS 7213, Faculté de Pharmacie, Université de Strasbourg, France. 4. Emergency Department, Fédération de Médecine Translationnelle, Strasbourg Regional University Hospital, France. 5. Department of cardiology, Strasbourg Regional University Hospital, France.
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.
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.
Authors: Nuria Rodríguez-Núñez; Alberto Ruano-Raviña; Adriana Lama; Lucía Ferreiro; Jorge Ricoy; José M Álvarez-Dobaño; Juan Suárez-Antelo; M Elena Toubes; Carlos Rábade; Antonio Golpe; Tamara Lourido; Francisco Javier González-Barcala; Luis Valdés Journal: J Thorac Dis Date: 2020-10 Impact factor: 3.005
Authors: Philip Mease; Christina Charles-Schoeman; Stanley Cohen; Lara Fallon; John Woolcott; Huifeng Yun; Joel Kremer; Jeffrey Greenberg; Wendi Malley; Alina Onofrei; Keith S Kanik; Daniela Graham; Cunshan Wang; Carol Connell; Hernan Valdez; Manfred Hauben; Eric Hung; Ann Madsen; Thomas V Jones; Jeffrey R Curtis Journal: Ann Rheum Dis Date: 2020-08-05 Impact factor: 19.103