Lipid levels do not influence the risk of venous thromboembolism

Abstract

SummaryStudies on the association between lipid profile and venous thromboembolism (VTE) are inconsistent. This could be caused by classical lipoproteins being inferior to apolipoproteins as markers for VTE risk. Therefore, we examined whether apolipoproteins are more strongly related to VTE than lipoproteins. For this analysis we used the PREVEND prospective community based observational cohort study. Levels of apolipoprotein A1 (ApoA1), apolipoprotein B (ApoB), total cholesterol (TC), high-density lipoprotein (HDL), non-HDL, low-density lipoprotein (LDL), triglycerides (TG), lipoprotein(a), ApoB/ApoA1 and TC/HDL ratio were assessed. Subjects with VTE were identified using databases of the national registries of hospital discharge diagnoses, death certificates, and the regional anticoagulation clinic. Out of 7,627 subjects, 110 developed VTE during a median follow-up of 10.5 years. In both univariate and multivariable analyses no significant associations be- tween apolipoproteins and overall VTE were observed. Of the classical lipoproteins, TC, non-HDL, LDL, TG, and TC/HDL ratio were significantly associated with overall VTE in univariate analysis. Significant associations were no longer present in multivariable analysis. TGL and LDL were significantly associated with unprovoked VTE in univariate analysis. After adjustment for age and sex this significance was lost. No significant associations between (apo-) lipoproteins and provoked VTE were found. We conclude that apolipoproteins are not better in predicting VTE risk than the classical lipoproteins. Our population-based cohort study does not show an association between both apolipoproteins and the classical lipoproteins and VTE risk.

Lipid levels and risk of venous thrombosis: results from the MEGA-study

“…However, the majority of the reports on lipids and venous thrombosis in this meta-analysis were small case–control studies, and controlling for several confounders had not been possible [ 6 ]. Our results follow the majority of the longitudinal studies published after the aforementioned meta-analysis [ 6 ], that collectively showed little to no evidence of an association between the major lipid levels and risk of venous thrombosis [ 7 , 10 – 12 ].…”

“…In contrast to the major lipids, fewer reports have addressed the relationship between venous thrombosis and levels of apo B and apo A1. In two cohort studies [ 8 , 12 ] neither apolipoprotein was associated with risk of venous thrombosis. In the other reports, an association between these apolipoproteins and venous thrombosis was restricted to certain subgroups.…”

“…In a hospital-based case–control study, high apo B levels appeared to increase the risk of venous thrombosis mainly in men [ 13 ]. Differences related to the study design, the source and selection criteria of the study population, the sample size, and the adjustment for potential confounders might have contributed to the contradictory results among these studies [ 8 , 9 , 12 , 13 , 29 ].…”

Severe hypertriglyceridaemia during therapy for childhood acute lymphoblastic leukaemia

“…Although the association of hypertriglyceridemia with coronary artery disease is well known, [29] its association with venous thromboembolism is unclear and might be related to changes in the fibrinolytic system[30]. A few case reports describe thrombosis in ALL patients with hypertriglyceridemia [7, 12] but in our study, approximately 20% of patients with severe hypertriglyceridemia developed venous thromboembolism.…”

Budd-Chiari Syndrome with Multiple Thrombi due to a Familial Arg42Ser Mutation in the Protein C Gene

“…The hypothesis maintains that elevated levels of total cholesterol may be a risk factor for venous thromboembolism (VTE). Studies on the association between lipid profile and VTE are inconsistent, with some reporting that total cholesterol is the risk factor [24], while others report that lipid levels do not influence the risk of VTE; however, the levels of LDL are significantly associated with unprovoked VTE as revealed by univariate analysis [25]. Further, statins can prevent VTE [26].…”