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Deep vein thrombosis and pulmonary embolism in two cohorts: the longitudinal investigation of thromboembolism etiology.

TitleDeep vein thrombosis and pulmonary embolism in two cohorts: the longitudinal investigation of thromboembolism etiology.
Publication TypeJournal Article
Year of Publication2004
AuthorsCushman M, Tsai AW, White RH, Heckbert SR, Rosamond WD, Enright P, Folsom AR
JournalAm J Med
Volume117
Issue1
Pagination19-25
Date Published2004 Jul 01
ISSN0002-9343
KeywordsAged, Case-Control Studies, Cohort Studies, Female, Follow-Up Studies, Humans, Incidence, Male, Middle Aged, Neoplasms, Population Surveillance, Pulmonary Embolism, Recurrence, Risk Factors, Survival Rate, Venous Thrombosis
Abstract

PURPOSE: To determine the incidence of deep vein thrombosis and pulmonary embolism in two cohorts representing regions of the United States.

METHODS: The sample comprised 21,680 participants of the Atherosclerosis Risk in Communities study and the Cardiovascular Health Study. Subjects were aged >/=45 years, resided in six communities, and were followed for 7.6 years. All hospitalizations were identified and thromboses were validated by chart review.

RESULTS: The age-standardized incidence of first-time venous thromboembolism was 1.92 per 1000 person-years. Rates were higher in men than women, and increased with age in both sexes. There was no antecedent trauma, surgery, immobilization, or diagnosis of cancer for 48% (175/366) of events. The 28-day case-fatality rate was 11% (29/265) after a first venous thromboembolism and 25% (17/67) for cancer-associated thrombosis. The recurrence rate 2 years after a first venous thromboembolism was 7.7% per year (95% confidence interval [CI]: 4.5% to 10.9% per year). Cancer was the only factor independently associated with 28-day fatality (relative risk [RR] = 5.2; 95% CI: 1.4 to 19.9) or recurrent thrombosis (RR = 9.2; 95% CI: 2.0 to 41.7).

CONCLUSION: The incidence of venous thromboembolism in this cohort of middle- and older-aged subjects was similar to that observed in more geographically homogeneous samples. Half of cases were idiopathic. Short-term mortality and 2-year recurrence rates were appreciable, especially among subjects with cancer. Based on this study we estimate that 187,000 cases of first-time venous thromboembolism are diagnosed yearly in the United States among those aged 45 years or older.

DOI10.1016/j.amjmed.2004.01.018
Alternate JournalAm J Med
PubMed ID15210384
Grant ListHC-55015 / HC / NHLBI NIH HHS / United States
HC-55016 / HC / NHLBI NIH HHS / United States
HC-55018 / HC / NHLBI NIH HHS / United States
HC-55019 / HC / NHLBI NIH HHS / United States
HC-55020 / HC / NHLBI NIH HHS / United States
HC-55021 / HC / NHLBI NIH HHS / United States
HC-55022 / HC / NHLBI NIH HHS / United States
HC-85079 / HC / NHLBI NIH HHS / United States
HC-85086 / HC / NHLBI NIH HHS / United States
HL59367 / HL / NHLBI NIH HHS / United States