Differential risks in men and women for first and recurrent venous thrombosis: the role of genes and environment

Abstract

To cite this article: Roach REJ, Cannegieter SC, Lijfering WM. Differential risks in men and women for first and recurrent venous thrombosis: the role of genes and environment. J Thromb Haemost 2014; 12: 1593-600.Summary. Men have a higher risk of first and recurrent venous thrombosis than do women. However, the pathophysiology underlying this phenomenon is as yet unknown. In this review article, we assessed the prevalence and strength of genetic and acquired risk factors for venous thrombosis for men and women separately, because it is likely that either a difference in effect or distribution of a risk factor explains the risk difference between the sexes. We also summarized the sex-specific results of previous studies on the risk of first and recurrent venous thrombosis. Few explanations for the sex difference were found. The major factor, explaining about 20% difference in population-attributable fraction, was body height. No difference in prevalence or strength for other venous thrombosis risk factors was observed, such as plaster cast immobilization, hospitalization, surgery, trauma, malignancy, hyperhomocysteinemia, factor V Leiden, prothrombin G20210A, or blood group non-O. Alternative explanations for the sex difference are hypothesized in this review, including X-or Y-linked mutations or a mutation on a gene with a sex-specific effect. Future studies should focus on the sex-specific risk of venous thrombosis to unravel the pathophysiology and thereby improve sex-specific treatment and prevention strategies. Even so, male sex can be used as a tool through which individuals at increased risk of first or recurrent venous thrombosis may be identified.

Recurrence and mortality after first venous thromboembolism in a large population‐based cohort

“…Most previous studies have reported a two‐fold to four‐fold higher recurrence rate among men than among women . In our study, we confirmed this trend, but the relative risk of recurrence was only 30% higher in men than in women, and the difference was not statistically significant.…”

Predictive factors of splanchnic vein thrombosis in acute pancreatitis: A 6‐year single‐center experience

“…Our results showed a higher rate of SVT in men (89.4%, P = 0.007), which is in agreement with the study of Roach et al who recently showed a higher risk of first and recurrent venous thrombosis in male patients. 16 SVT was also more common in our patients who smoked (P = 0.003). Smoking, especially heavy smoking, is a known risk factor for thrombosis.…”

“…2 Splanchnic vein thrombosis (SVT) is a typical complication of AP, occurring in 1. [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22].6% of the cases. 1,5 It is usually discovered either incidentally on CT scan that is performed to assess the severity of the pancreatitis or during the follow-up.…”

Differential risks in men and women for first and recurrent venous thrombosis: the role of genes and environment: comment

“…Differential risks in men and women for first and recurrent venous thrombosis: the role of genes and environment: reply We would like to thank Xu and Schooling for their comment containing an interesting meta-analysis in which they showed that patients treated with exogenous testosterone had an almost 5-fold increased risk of venous thrombosis [1]. Although we agree that this result adds credence to the hypothesis that exogenous testosterone increases venous thrombosis risk, for a number of reasons, it still seems unlikely that a difference in endogenous testosterone levels between men and women can explain the sex difference for venous thrombosis.…”