The risk of venous thromboembolism is markedly elevated in patients with diabetes

Abstract

Aims/hypothesis: Diabetes mellitus is associated with several changes in coagulation and fibrinolysis that may lead to a thrombogenic propensity. However, it is not known whether these perturbations actually cause increased risk of venous thromboembolism. Methods: In a retrospective population-based study we evaluated the medical records of all 302 adult patients who were admitted to the Umeå University Hospital with verified deep vein thrombosis or pulmonary embolism during the years 1997 to 1999. The patients were classified as diabetic (n=56) and non-diabetic (n=246) according to clinical information. The total number of diagnosed diabetic patients in different age groups in the catchment area was obtained from computerised registries in the primary health care centres and the Umeå University Hospital, and data on the background population were collected from the Swedish population registry. Results: The annual incidence rate of venous thromboembolism among diabetic patients in the population was 432 per 100,000 individuals (95% CI 375-496). In non-diabetic individuals it was 78 (95% CI 68-88). The age-adjusted incidence rate among the diabetic population was 274 (95% CI 262-286). The annual incidence rate of venous thromboembolism was elevated in type 1 and type 2 diabetic patients and the incidence rates were 704 (95% CI 314-1,566) and 412 (95% CI 312-544) respectively. The overall standardised morbidity ratio was 2.27 (95% CI 1.75-2.95), i.e. diabetic patients were more prone to venous thromboembolism after adjustment for age differences. Conclusions/interpretation: These results suggest that the age-adjusted risk for venous thromboembolism is more than two-fold higher among diabetic patients than in the non-diabetic background population.

Venous thromboembolism a manifestation of the metabolic syndrome

“…[36][37][38][39] Arterial hypertension and diabetes have also been found to be associated with VTE. 40,41 We were able to measure hs-CRP, fibrinogen and factor VIII activity in our study and these parameters were significantly elevated in the subgroup of individuals with the metabolic syndrome, which is concordant with previously reported data. 16, 21-23, 30, 31 People with the metabolic syndrome frequently have a pro-inflammatory state, as shown by increased acute-phase reactants (e.g., CRP, fibrinogen), 30,31 and also a prothrombotic state due to elevated levels of fibrinogen, PAI-1, and clotting factors.…”

Deep vein thrombosis in patients with advanced liver cirrhosis: a rare condition?

“…This observation was not surprising since the risk of VTE is increased in diabetic patients [11]. Other features of endocrinal disturbance, such as obesity and dyslipidemia, might be risk factors of DVT; however, a recent study concluded that symptoms of metabolic syndrome were not clinically important risk factors for VTE [12].…”

Endothelium, venous thromboembolism and ischaemic cardiovascular events

“…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).…”