Cardiovascular Risk Factors Associated With Venous Thromboembolism
Rimm, Eric B
Lowe, Gordon DO
Thompson, Simon G
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Gregson, J., Kaptoge, S., Bolton, T., Pennells, L., Willeit, P., Burgess, S., Bell, S., et al. (2019). Cardiovascular Risk Factors Associated With Venous Thromboembolism. JAMA Cardiology, 1 (2. 10.1001/jamacardio.2018.4537)https://doi.org/10.1001/jamacardio.2018.4537
Importance It is uncertain to what extent established cardiovascular risk factors are associated with venous thromboembolism (VTE). Objective To estimate associations between major cardiovascular risk factors and VTE, i.e., deep-vein thrombosis (DVT) and pulmonary embolism (PE). Design Analysis of individual-participant data from the Emerging Risk Factors Collaboration (ERFC; 731,728 participants; 75 cohorts; latest date of follow-up 2015), and UK Biobank (UKBB; 421,537 participants; latest date of follow-up 2016). Setting Approximately population-based prospective cohort studies. Participants Individuals without cardiovascular disease at baseline. Exposures A panel of several established cardiovascular risk factors. Main Outcomes and Measures Hazard ratios (HRs) per 1-SD higher risk factor levels (or presence/absence). Incident fatal outcomes in ERFC (n=1041 VTE, n=25,131 CHD) and incident fatal/non-fatal outcomes in UKBB (n=2321 VTE, n=3385 CHD). HRs were adjusted for age, sex, smoking status, diabetes mellitus, and body-mass index. Results Adjusted HRs for VTE were: 2.67 (2.45-2.91) in ERFC and 1.81 (1.71-1.92) in UKBB per decade older age; 1.38 (1.20-1.58) in ERFC and 1.23 (1.08-1.40) in UKBB with smoking; 1.43 (1.35-1.50) in ERFC and 1.37 (1.32-1.41) in UKBB per 1-SD higher body-mass index; and 0.75 (0.61-0.93) in ERFC and 0.82 (0.71-0.94) in UKBB with current alcohol consumption. For the preceding factors, there were similar HRs for pulmonary embolism versus deep vein thrombosis in UKBB (except adiposity was more strongly associated with PE; P<0.01), and similar HRs for unprovoked versus provoked VTE. Apart from adiposity, these risk factors were less strongly associated with VTE than coronary heart disease. We noted inconsistent associations with diabetes and blood pressure for VTEs across ERFC and UKBB, and had limited ability to study lipid and inflammation markers. Conclusions and Relevance Older age, smoking, adiposity, and lower alcohol consumption were consistently associated with higher VTE risk.
A study website (http://www.phpc.cam.ac.uk/ceu/erfc/list-of-studies/) includes a list that investigators have provided of funding agencies that have supported individual cohorts in the ERFC contributing to the present consortium. This research has been conducted using the UK Biobank resource (application 26865).
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External DOI: https://doi.org/10.1001/jamacardio.2018.4537
This record's URL: https://www.repository.cam.ac.uk/handle/1810/288209
Attribution 4.0 International (CC BY)
Licence URL: http://creativecommons.org/licenses/by/4.0/