Aetiologies and prognosis of Chinese patients with deep vein thrombosis of the lower extremities

Peng, Yen-Yi; Jeng, Jiann‐Shing; Shen, Mengni; Tsay, Woei; Wang, B S; Lin, W H; Chang, Yaowen; Yip, Ping-Keung

doi:10.1093/qjmed/91.10.681

Cited by 17 publications

(14 citation statements)

References 6 publications

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“…The high prevalence of thrombophilia markers (protein C, protein S, and APLA) in our patients as compared with Caucasians has been reported from other Asian groups [21][22][23]. In contrast, surgery and fractures are often described as major risk factors for DVT in Caucasian populations [24,25].…”

Section: Discussionsupporting

confidence: 55%

Cause of deep venous thrombosis and pulmonary embolism in young patients from India as compared with other ethnic groups

Pai

Ghosh

Shetty

2012

Blood Coagulation &Amp; Fibrinolysis

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Venous thromboembolism (VTE), which consists of deep vein thrombosis (DVT) and pulmonary embolism, is a potentially fatal disease. The existing Asian literature has shown a wide variation in the prevalence of VTE, with very limited data from India. In the present study, the risk factors for VTE in Indian patients were compared with Caucasians and Blacks. We used data prospectively collected from total of 1396 Indian patients (716 males, 680 females) enrolled over a decade and compared with White (n = 2002) and Black (n = 395) patients objectively diagnosed with VTE. When compared with females, males had significantly higher episodes of pulmonary embolism and VTE (P = 0.0001). Amongst the known thrombophilia markers, only homocysteine was found to be significantly higher in males as compared with females (P = 0.006). Males had a higher proportion of rheumatic heart disease (RHD) and ischaemic heart disease (IHD) as compared with females. The prevalence of DVT amongst Indians was significantly higher as compared with Whites and Blacks. However, the rate of pulmonary embolism and VTE was lower in Indians as compared with both the races. Amongst the baseline characteristics identified as risk factors for VTE, Indians had a higher prevalence of infection as compared to both Whites and Blacks, but lower HIV infection as compared to Blacks. As compared to Whites, Indians had lower prevalence of idiopathic VTE (but similar to blacks) and had higher prevalence of idiopathic pulmonary embolism (P < 0.0001). This can be explained by different inherited and environment risk factors between these three populations.

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Section: Discussionsupporting

confidence: 55%

Cause of deep venous thrombosis and pulmonary embolism in young patients from India as compared with other ethnic groups

Pai

Ghosh

Shetty

2012

Blood Coagulation &Amp; Fibrinolysis

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“…While Asian populations have lower mean BMI than Europeans, the mean BMI of Maori and Pacific Island groups is higher [31]; therefore BMI alone does not account for the reduced incidence of VTE in the non-European populations. Other speculated environmental explanations for the lower rates of VTE among non-European populations include dietary differences and differing use of herbal medications [32]. Even without established explanations, a significant difference in the incidence of a condition among different ethnic groups brings into question our current practice of using the same algorithms to manage all VTE patients regardless of ethnic status.…”

Section: Discussionmentioning

confidence: 99%

Incidence of venous thromboembolism in different ethnic groups: a regional direct comparison study

Liao

Woulfe

Hyder

et al. 2014

Journal of Thrombosis and Haemostasis

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Summary Background There are few studies that directly compare the variation in incidence of venous thromboembolism (VTE) according to ethnicity. Objective The aim of this study was to compare the rates of VTE, deep venous thrombosis (DVT) and pulmonary embolism (PE) among different ethnic groups. Method The cases diagnosed with VTE, DVT and PE for a period between March 2004 and June 2009 were identified through the hospital‐based database system. The 2006 New Zealand Census data were used to calculate the rate of diagnosis. Results The observed annual incidence of VTE during this period was 81.6 per 100 000 population. The relative risks of VTE when comparing European subjects with Maori, Pacific Island and Asian subjects after age standardization were 1.98 (95% confidence interval [CI], 1.63–2.41), 3.22 (95% CI, 2.60–3.99) and 4.02 (95% CI, 3.34–4.84), respectively. Relative risks of DVT after age standardization when comparing European subjects with Maori, Pacific Island and Asian subjects, were 2.14 (95% CI, 1.72–2.66), 3.20 (95% CI, 2.46–4.17) and 4.75 (95% CI, 3.80–5.94), respectively. Indirect age standardization was used for comparison of the diagnosis of PE. The ratio between the calculated expected number of cases and the actual number of cases was 1.32 (95% CI, 0.89–1.75) for Maori subjects, 2.96 (95% CI, 1.89–4.03) for Pacific Islanders and 3.89 (95% CI, 3.00–4.78) for Asians. Conclusion Europeans have a significantly higher incidence of VTE compared with Maori, Pacific Island and Asian populations.

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“…A review of patient characteristics from a Japanese PE registry study found a slight female preponderance (female:male ratio 1·26) and a high proportion of idiopathic events (58% of 307 patients) (Nakamura et al , 2001). Retrospective studies in Taiwan and Singapore, investigating inpatient diagnoses of DVT, found malignancy, immobility and known thrombophilia to be important risk factors (Peng et al , 1998; Tan et al , 2007). Leung et al (2006) undertook a prospective study in 1754 Chinese medical inpatients (not receiving thromboprophylaxis) investigating those who developed clinical symptoms of DVT or a rise in d ‐dimer during their medical admission with lower limb Doppler ultrasound.…”

Section: Epidemiology Of Vtementioning

confidence: 99%

Venous thromboembolism and ethnicity

2009

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SummaryVenous thromboembolism (VTE) has long been considered a disease that affects predominantly white populations, a misconception resulting from a paucity of epidemiological data from non-Western countries, and the low incidence of hereditary thrombophilia in those of non-Caucasian background. Over the last decade, interest has grown in this area with the emergence of evidence that VTE is as prevalent, if not more so, in the black population and is also common in Asian groups. Much is still to be learned, as our current knowledge of hereditary thrombophilia and acquired risk factors do not fully explain the risk of VTE in non-Caucasian groups. This review summarises the current understanding of ethnic variation in VTE and highlights the need for further research in this area.

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Aetiologies and prognosis of Chinese patients with deep vein thrombosis of the lower extremities

Cited by 17 publications

References 6 publications

Cause of deep venous thrombosis and pulmonary embolism in young patients from India as compared with other ethnic groups

Cause of deep venous thrombosis and pulmonary embolism in young patients from India as compared with other ethnic groups

Incidence of venous thromboembolism in different ethnic groups: a regional direct comparison study

Venous thromboembolism and ethnicity

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