Venous thromboembolism and the risk of subsequent symptomatic atherosclerosis

Abstract

Summary. Background: Recently, we reported an association between asymptomatic carotid atherosclerosis and venous thromboembolism (VTE) of unknown origin. We hypothesized that patients with VTE of unknown origin would be at a higher risk of developing symptomatic atherosclerosis than patients with VTE induced by known risk factors. Methods: To examine this hypothesis, we studied 1919 consecutive patients followed prospectively after their first VTE episode. The primary outcome was non-fatal and fatal symptomatic atherosclerotic disease in patients with VTE of unknown origin as compared to those with secondary VTE. An independent committee assessed all study outcomes, and adjusted hazard ratios (HR) were calculated using the Cox's proportional hazards model. Results:After a median follow-up of 48 and 51 months, respectively, at least one symptomatic atherosclerotic complication was detected in 160 of the 1063 patients (15.1%) with VTE of unknown origin, and in 73 of the 856 (8.5%) with secondary VTE. After adjusting for age and other risk factors of atherosclerosis, the HR for symptomatic atherosclerotic complications in patients with VTE of unknown origin compared to those with secondary VTE was 1.6 (95% confidence intervals; CI: 1.2-2.0). When the analysis was restricted to patients without previous symptomatic atherosclerosis, the HR became 1.7 (95% CI: 1.1-2.4). Conclusions: Patients with VTE of unknown origin have a 60% higher risk of developing symptomatic atherosclerotic disease than do patients with secondary venous thrombosis.

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

“…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.…”

Venous thromboembolism a manifestation of the metabolic syndrome

“…Our data and those from the literature may strengthen the hypothesis of an association between atherosclerosis and venous thrombosis, which is the subject of animated discussion. [3][4][5][6][7]13,14,32,33 Analyzing the components of the metabolic syndrome individually, abdominal obesity was demonstrated to be of predictive value for both coronary heart disease and VTE. 9,34 Dyslipidemia has long been known to be a risk factor for atherothrombotic disorders.…”

“…There is accumulating evidence for an association between VTE and atherosclerosis. [3][4][5][6][7] VTE and atherosclerosis may share common risk factors. For example, obesity in general and abdominal obesity in particular are also well accepted risk factors for VTE and were reported to be associated with impaired fibrinolytic activity, which may be a predisposing mechanism to arterial as well as to venous thrombosis.…”

Diagnosis and Treatment of Lower Extremity Deep Vein Thrombosis: Korean Practice Guidelines

“…For instance, the 10-year cumulative risk of symptomatic vascular events among patients with idiopathic DVT is 25.4%, compared with 12.9% in those with secondary VTE [26]. Patients with idiopathic DVT also have a higher prevalence of atherosclerotic risk factors (diabetes, hypertension, and hypercholesterolemia) and coronary artery calcium than control group without VTE [27].…”