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Prospective study of subclinical atherosclerosis as a risk factor for venous thromboembolism.

TitleProspective study of subclinical atherosclerosis as a risk factor for venous thromboembolism.
Publication TypeJournal Article
Year of Publication2006
AuthorsReich LM, Folsom AR, Key NS, Boland LL, Heckbert SR, Rosamond WD, Cushman M
JournalJ Thromb Haemost
Volume4
Issue9
Pagination1909-13
Date Published2006 Sep
ISSN1538-7933
KeywordsAtherosclerosis, Carotid Arteries, Carotid Artery Thrombosis, Female, Humans, Incidence, Male, Middle Aged, Prospective Studies, Risk Factors, Thromboembolism, Ultrasonography, Venous Thrombosis
Abstract

BACKGROUND: Whether atherosclerotic disease predisposes to venous thrombosis is uncertain.

OBJECTIVE: To determine whether subclinical atherosclerosis, manifested as increased carotid intima-media thickness (IMT) or presence of carotid plaque, is associated with increased incidence of venous thromboembolism (VTE).

PATIENTS AND METHODS: The Atherosclerosis Risk in Communities study is a prospective cohort of adults aged 45-64 years, examined at baseline (1987-89) and followed for cardiovascular events. Bilateral carotid ultrasound for IMT measurements was done at baseline for portions of the common and internal carotid arteries, and carotid bifurcation and also to detect the presence of carotid plaque. Exclusion criteria included baseline anticoagulant use, history of coronary heart disease, stroke, or VTE, and incomplete data. First VTE during follow-up was validated using abstracted medical records.

RESULTS: Among 13,081 individuals followed for a mean of 12.5 years, 225 first VTE events were identified. Unadjusted hazard ratios (HR) (95% CI) of VTE across quartiles of baseline IMT were 1.0, 1.16 (0.77-1.75), 1.64 (1.12-2.40), and 1.52 (1.03-2.25). However, this association disappeared after adjustment for age, sex, and ethnicity (HRs: 1.0, 1.06, 1.40, and 1.18). Further adjustment for body mass index and diabetes weakened the relative risks even further. Presence of carotid plaque at baseline also was not associated with VTE occurrence; adjusted HR = 0.97, 95% CI = 0.72-1.29.

CONCLUSION: Increased carotid IMT or presence of carotid plaque was not associated with an increased incidence of VTE in this middle-aged cohort, suggesting subclinical atherosclerosis itself is not a VTE risk factor.

DOI10.1111/j.1538-7836.2006.02121.x
Alternate JournalJ Thromb Haemost
PubMed ID16836659
Grant ListHL-007062-27 / HL / NHLBI NIH HHS / United States
N01-HC-55015 / HC / NHLBI NIH HHS / United States
N01-HC-55016 / HC / NHLBI NIH HHS / United States
N01-HC-55018 / HC / NHLBI NIH HHS / United States
N01-HC-55019 / HC / NHLBI NIH HHS / United States
N01-HC-55020 / HC / NHLBI NIH HHS / United States
N01-HC-55021 / HC / NHLBI NIH HHS / United States
N01-HC-55022 / HC / NHLBI NIH HHS / United States