Family history of myocardial infarction is an independent risk factor for venous thromboembolism: the Tromsø study

Abstract

To cite this article: Braekkan SK, Mathiesen EB, Njølstad I, Wilsgaard T, Størmer J, Hansen JB. Family history of myocardial infarction is an independent risk factor for venous thromboembolism: the Tromsø study. J Thromb Haemost 2008; 6: 1851-7.Summary. Background: Recent studies indicate that arterial cardiovascular diseases and venous thromboembolism (VTE) share common risk factors. A family history of myocardial infarction (MI) is a strong and independent risk factor for future MI. Objectives: The purpose of the present study was to determine the impact of cardiovascular risk factors, including family history of MI, on the incidence of VTE in a prospective, population-based study. , 1.21; 95% CI, 1.13-1.31), and family history of MI (HR, 1.31; 95% CI, 1.04-1.65) were significantly associated with VTE. Family history of MI remained a significant risk factor for total VTE (HR, 1.27; 95% CI, 1.01-1.60) and unprovoked VTE (HR, 1.46; 95% CI, 1.03-2.07) in multivariable analysis. Blood pressure, total cholesterol, HDL-cholesterol, triglycerides, and smoking were not independently associated with total VTE. Conclusions: Family history of MI is a risk factor for both MI and VTE, and provides further evidence of a link between venous and arterial thrombosis.Keywords: atherosclerosis, family history, risk factors, venous thrombosis.Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is a common disease, with serious short-and long-term complications, and a potential fatal outcome [1]. It affects 1-3 per 1000 adults each year [1,2], and is the third most common cardiovascular disease [3]. Although surgery, trauma, hospitalization, malignancy, immobilization, pregnancy, use of oestrogens, and inherited thrombophilia are associated with VTE [1,4], approximately 30-50% of the events occur in the absence of obvious predisposing factors [5].The concept that VTE and atherosclerotic cardiovascular diseases are two distinct disease entities has recently been challenged. A higher frequency of carotid plaques in patients with idiopathic VTE has been reported [6]. The long-term incidence of cardiovascular disease is reported to be substantially increased in patients with VTE, compared to population controls [7]. A recent meta-analysis, based on selected prospective studies and case-control studies with verified endpoints, concluded that cardiovascular risk factors were associated with VTE [8]. However, prospective studies on the relation between traditional cardiovascular risk factors and VTE show diverging results. In the NursesÕ Health Study, obesity, cigarette smoking, and hypertension, but not diabetes or elevated cholesterol, were independent predictors for PE [9]. In the PhysiciansÕ Health Study [3], only body mass index (BMI) and height were identified as independent risk factors for VTE, whereas smoking and abdominal obesity were predictors for VTE in another study on middle-aged men [10]. In the LITE-study, obesity and diabetes, but not cigarette smoking, hypertension, and dysli...

Mean platelet volume is a risk factor for venous thromboembolism: the Tromsø study

“…Altogether, these studies support the hypothesis that platelet activation may also play a role in the pathogenesis of VTE. Recent studies indicate a link between arterial cardiovascular diseases and VTE, suggesting that arterial thromboembolism and VTE may share common genetic or environmental risk factors [7,[31][32][33]. Age, BMI and acute infections are well-established risk factors for both arterial and venous thrombosis.…”

“…Age, BMI and acute infections are well-established risk factors for both arterial and venous thrombosis. However, large prospective cohort studies have failed to show an association between VTE and other traditional cardiovascular risk factors, such as smoking, blood pressure, triglycerides, and cholesterol [3,32,34]. Increased levels of MPV are found in patients with coronary artery disease [14,15], and MPV has been identified as an independent risk factor for myocardial infarction and stroke [16][17][18].…”

Endothelium, venous thromboembolism and ischaemic cardiovascular events

“…In particular, acute reactions to infectious agents are associated with an increased risk of both arterial ischaemic events and VTE and are accompanied by both arterial and venous endothelial dysfunction (40,43,44); increased circulating levels of some biomarkers of endothelial dysfunction, like endothelial microparticles or P-selectin, are associated with both an enhanced risk of cardiovascular events and of VTE (45)(46)(47); recent data have shown in patients with VTE an increase of circulating fibronectin, an endothelium-released plasma factor previously shown to correlate with arterial endothelial dysfunction (48,49); several other clinical conditions characterised by an impaired arterial endothelial function, like airpollution, chronic HIV infection, a family history of myocardial infarction, the metabolic syndrome, rheumatoid arthritis and microalbuminuria, have been reported to be associated not only with an increased risk of arterial events but also of venous thrombosis (12,14,16,19,21,22,(50)(51)(52).…”

“…Furthermore, the increased incidence of VTE in patients with risk factors for arterial cardiovascular events points too to a common pathogenesis (6). Indeed, a number of studies, with different design and in various clinical settings, have shown an increased risk of VTE associated with most of the classic or novel risk factor for ischaemic cardiovascular disease (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22) (ǠTable 1).…”

Arterial cardiovascular risk factors and venous thrombosis: results from a population-based, prospective study (the HUNT 2)

“…8 Casecontrol investigations have indicated an association between venous thrombosis and dyslipidemia, and smoking, 10,11 but cohort studies have not confirmed these findings. [12][13][14][15] It is still uncertain whether hypertension and diabetes are significant risk factors for venous thrombosis. 9,12,16,17 There is only one published study investigating the role of a positive family history for arterial thrombosis.…”