An Association between Atherosclerosis and Venous Thrombosis

Prandoni, Paolo; Bilora, Franca; Marchiori, Antonio; Bernardi, Enrico; Petrobelli, Francesco; Lensing, Anthonie W. A.; Prins, Martin H.; Girolami, Antonio

doi:10.1056/nejmoa022157

Cited by 573 publications

(459 citation statements)

References 38 publications

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“…However, a number of studies have shown that idiopathic VTE is associated with an increased risk of subsequent cardiovascular events and that patients with idiopathic VTE have an increased prevalence of asymptomatic atherosclerotic lesions. [38][39][40] Because PCOS is associated with atherosclerotic disease, a relationship with venous diseases needs to be considered. Our findings, therefore, do have connotations that might be relevant in clinical settings.…”

Section: Commentmentioning

confidence: 99%

Is polycystic ovary syndrome another risk factor for venous thromboembolism? United States, 2003–2008

Okoroh

Hooper

Atrash

et al. 2012

American Journal of Obstetrics and Gynecology

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OBJECTIVE-We sought to determine prevalence and likelihood of venous thromboembolism (VTE) among women with and without polycystic ovary syndrome (PCOS). STUDY DESIGN-We performed a cross-sectional analysis using Thomson Reuters MarketScanCommercial databases for the years 2003 through 2008. The association between VTE and PCOS among women aged 18-45 years was assessed using age-stratified multivariable logistic regression models.RESULTS-Prevalence of VTE per 100,000 was 374.2 for PCOS women and 193.8 for women without PCOS. Compared with women without PCOS, those with PCOS were more likely to have VTE (adjusted odds ratio [aOR] 18-24 years, 3.26; 95% confidence interval [CI], 2.61-4.08; aOR 25-34 years, 2.39; 95% CI, 2.12-2.70; aOR 35-45 years, 2.05; 95% CI, 1.84-2.38). A protective association (odds ratio, 0.8; 95% CI, 0.73-0.98) with oral contraceptive use was noted for PCOS women.CONCLUSION-PCOS might be a predisposing condition for VTE, particularly among women aged 18-24 years. Oral contraceptive use might be protective. Keywordspolycystic ovary syndrome; prevalence; venous thromboembolism Venous thromboembolism (VTE) is a chronic condition that includes both deep vein thrombosis (DVT) and pulmonary embolism (PE). Initial presentation might be leg pain, tenderness, shortness of breath, or pleuritic chest pain, or there might be no symptoms. 1 VTE is the third most common cardiovascular disease-after myocardial infarction and stroke-among the general population. 2,3 The overall annual incidence of VTE is estimated © 2012 Mosby, Inc. All rights reserved.Reprints: Ekwutosi M. Okoroh, MD, Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Rd., Mailstop E64, Atlanta, GA 30333. Eokoroh@cdc.gov. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.The authors report no conflict of interest.Presented orally at the 60th Annual Epidemic Intelligence Service Conference, Atlanta, GA, April 11-15, 2011. HHS Public Access Author Manuscript Author ManuscriptAuthor Manuscript Author Manuscript to be 1-2 per 1000 adults per year. [4][5][6][7] These incident estimates, however, might not represent the entire population because VTE incidence differs by age and race, and slightly by sex. VTE is a multifactorial disease with both inherited and acquired risk factors. In 26-47% of first-time VTE cases, the etiology is unknown 4,5,8 ; a possible predisposing condition not yet assessed is polycystic ovary syndrome (PCOS).PCOS is the most common endocrine disorder affecting women of reproductive age. Estimates of its prevalence vary and range from 4-6%. 9-12 Its exact etiology is unknown, but it is characterized by a heterogeneous presentation of hyperandrogenism, ovulatory dysfunction, and polycystic ovaries. 13 PCOS is also associated with insulin-induced elevations of plasminogen activator inhibitor (P...

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Section: Commentmentioning

confidence: 99%

Is polycystic ovary syndrome another risk factor for venous thromboembolism? United States, 2003–2008

Okoroh

Hooper

Atrash

et al. 2012

American Journal of Obstetrics and Gynecology

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“…postpartum, history of cancer, recent leg fracture and immobilization). 17 More recently, lower levels of high density lipoprotein cholesterol and higher levels of low density lipoprotein cholesterol were found in men with VTE compared to controls. 18 A meta-analysis of cardiovascular risk factors and VTE found that hypertension and obesity conferred increased risk for VTE compared to controls (OR 1.51 and 2.33, respectively).…”

Section: Discussionmentioning

confidence: 98%

Risk Factors for Venous Thromboembolism in Chronic Obstructive Pulmonary Disease

Kim¹,

Goel²,

Gangar³

et al. 2014

J COPD F

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Background COPD patients are at increased risk for venous thromboembolism (VTE). VTE however remains under-diagnosed in this population and the clinical profile of VTE in COPD is unclear. Methods Global initiative for chronic Obstructive Lung Disease (GOLD) stages II-IV participants in the COPD Genetic Epidemiology (COPDGene) study were divided into 2 groups: VTE+, those who reported a history of VTE by questionnaire, and VTE−, those who did not. We compared variables in these 2 groups with either t-test or chi-squared test for continuous and categorical variables, respectively. We performed a univariate logistic regression for VTE, and then a multivariate logistic regression using the significant predictors of interest in the univariate analysis to ascertain the determinants of VTE. Results The VTE+ group was older, more likely to be Caucasian, had a higher body mass index (BMI), smoking history, used oxygen, had a lower 6-minute walk distance, worse quality of life scores, and more dyspnea and respiratory exacerbations than the VTE− group. Lung function was not different between groups. A greater percentage of the VTE+ group described multiple medical comorbidities. On multivariate analysis, BMI, 6-minute walk distance, pneumothorax, peripheral vascular disease, and congestive heart failure significantly increased the odds for VTE by history. Conclusions BMI, exercise capacity, and medical comorbidities were significantly associated with VTE in moderate to severe COPD. Clinicians should suspect VTE in patients who present with dyspnea and should consider possibilities other than infection as causes of COPD exacerbation.

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“…The patients with pulmonary arterial thrombus had a higher probability of suffering coronary atherosclerosis and acute myocardial infarction. 6,7 Atherosclerosis is also a risk factor of pulmonary arterial thrombosis. 8 The patients with atherosclerosis had a higher probability of suffering PE.…”

Section: Discussionmentioning

confidence: 99%

Correlation Study of Pulmonary Embolism and High‐density Lipoprotein Cholesterol

Wang

2010

Clinical Cardiology

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Background: It is currently thought that pulmonary embolism and deep vein thrombosis are different manifestations of the same pathological process of venous thromboembolism. Venous thromboembolism has a negative correlation with high-density lipoprotein cholesterol. Hypothesis: Pulmonary embolism has a negative correlation with the level of high-density lipoprotein cholesterol. Methods: A total of 90 patients with pulmonary embolism, diagnosed and treated at a single center, were retrospectively analyzed for the present study. Among them were 57 cases of pulmonary arterial trunk embolism in group A and 33 cases of pulmonary arterial non-trunk embolism in group B.Results: The results showed that the level of high-density lipoprotein cholesterol decreased markedly in patients with pulmonary arterial trunk embolism as compared to those with pulmonary arterial non-trunk embolism. A stepwise logistic regression analysis was performed upon the relationship between pulmonary arterial trunk embolism and multiple factors. The results showed that a pulmonary arterial trunk embolism had a negative correlation with the level of high-density lipoprotein cholesterol and a positive correlation with triglyceride and high sensitivity C-reactive protein.Conclusions: Pulmonary arterial trunk embolism is negatively correlated with the level of high-density lipoprotein cholesterol.

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An Association between Atherosclerosis and Venous Thrombosis

Abstract: An association between atherosclerosis and venous thrombosisPrandoni, P.; Bilora, F.; Marchiori, A.; Bernardi, E.; Petrobelli, F.; Lensing, A.W.A.; Prins, M.; Girolami, A.

Cited by 573 publications

References 38 publications

Is polycystic ovary syndrome another risk factor for venous thromboembolism? United States, 2003–2008

Is polycystic ovary syndrome another risk factor for venous thromboembolism? United States, 2003–2008

Risk Factors for Venous Thromboembolism in Chronic Obstructive Pulmonary Disease

Correlation Study of Pulmonary Embolism and High‐density Lipoprotein Cholesterol

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