Venous thrombotic events in patients admitted to a tuberculosis centre

Howard, Jaime Borjas; Bierman, Wouter F W; Meijer, Karina; Werf, Tjip S. van der; Tichelaar, Ynse Ieuwe Gerardus Vladimir

doi:10.1093/qjmed/hcw152

Cited by 12 publications

(16 citation statements)

References 11 publications

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“…An infection with HIV results in an increased risk of a first venous thromboembolism (VTE) [1]. This is likely related to the observed procoagulant state in people with HIV (PWH) [2][3][4] and is in line with the increased first VTE rates associated with other infections [5][6][7][8]. Indeed, multiple cohorts found a 2-to 10-fold increased risk of a first VTE in PWH compared to the general population.…”

Section: Introductionmentioning

confidence: 95%

Risk of recurrent venous thromboembolism in patients with HIV infection: A nationwide cohort study

et al. 2020

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Background Multiple studies have described a higher incidence of venous thromboembolism (VTE) in people living with an HIV infection (PWH). However, data on the risk of recurrent VTE in this population are lacking, although this question is more important for clinical practice. This study aims to estimate the risk of recurrent VTE in PWH compared to controls and to identify risk factors for recurrence within this population. Methods and findings PWH with a first VTE were derived from the AIDS Therapy Evaluation in the Netherlands (ATHENA) cohort (2003-2015), a nationwide ongoing cohort following up PWH in care in the Netherlands. Uninfected controls were derived from the Multiple Environmental and Genetic Assessment of risk factors for venous thrombosis (MEGA) follow-up study (1999-2003), a cohort of patients with a first VTE who initially participated in a case-control study in the Netherlands who were followed up for recurrent VTE. Selection was limited to persons with an index VTE suffering from deep vein thrombosis in the lower limbs and/or pulmonary embolism (PE). Participants were followed from withdrawal of anticoagulation to VTE recurrence, loss to follow-up, death, or end of study. We estimated incidence rates, cumulative incidence (accounting for competing risk of death) and hazard ratios (HRs) using Cox proportional hazards regression, adjusting for age, sex, and whether the index event was

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Section: Introductionmentioning

confidence: 95%

Risk of recurrent venous thromboembolism in patients with HIV infection: A nationwide cohort study

et al. 2020

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“…TB is frequently associated with other chronic infections such as HIV infection and viral hepatitis. Hence, these patients may be at increased risk of thrombosis due to the aggregated inflammatory profile in case of co-infection [ 78 ]. In the study by Borjas-Howard et al [ 78 ] HIV co-infection was independently associated with VTE (adjusted OR: 8.2, CI 95% 2.9–22.7) ( Table 4 ).…”

Section: Tuberculosis and Vtementioning

confidence: 99%

“…Borjas-Howard et al [ 78 ] studied the risk of VTE in 750 patients, of which 18 (2.4%, 95% CI 1.4–3.8) suffered a VTE event. The median age at the time of VTE diagnosis was 42 years and 13 out of 18 VTE events happened in the time window of two weeks before the anti-TB treatment initiation.…”

Section: Tuberculosis and Vtementioning

confidence: 99%

Venous Thromboembolic Disease in Chronic Inflammatory Lung Diseases: Knowns and Unknowns

Κεραμίδας

Gourgoulianis

Kotsiou

2021

JCM

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Persistent inflammation within the respiratory tract underlies the pathogenesis of numerous chronic pulmonary diseases. There is evidence supporting that chronic lung diseases are associated with a higher risk of venous thromboembolism (VTE). However, the relationship between lung diseases and/or lung function with VTE is unclear. Understanding the role of chronic lung inflammation as a predisposing factor for VTE may help determine the optimal management and aid in the development of future preventative strategies. We aimed to provide an overview of the relationship between the most common chronic inflammatory lung diseases and VTE. Asthma, chronic obstructive pulmonary disease, interstitial lung diseases, or tuberculosis increase the VTE risk, especially pulmonary embolism (PE), compared to the general population. However, high suspicion is needed to diagnose a thrombotic event early as the clinical presentation inevitably overlaps with respiratory disorders. PE risk increases with disease severity and exacerbations. Hence, hospitalized patients should be considered for thromboprophylaxis administration. Conversely, all VTE patients should be asked for lung comorbidities before determining anticoagulant therapy duration, as those patients are at increased risk of recurrent PE episodes rather than DVT. Further research is needed to understand the underlying pathophysiology of in-situ thrombosis in those patients.

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“…Tuberculosis which is one of the most prevalent infectious diseases worldwide, has been described to be associated with high prevalence of VTE in some recent primary studies 6 8. The pathogenesis involved in the development of VTE in patients with tuberculosis (TB) is unclear.…”

Section: Introductionmentioning

confidence: 99%

“…However, the Virchow’s triad is thought to be at the core of the pathophysiology 9. Although the high burden of TB and VTE is clearly known, and evidence suggest a plausible association between TB and VTE,6 8 10–12 the relationship between them is still not well understood. Accordingly, we propose this global systematic review and meta-analysis protocol to critically synthesise current evidence on this association.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of venous thromboembolism in people with active tuberculosis: a systematic review and meta-analysis protocol

Awana¹,

Danwang²,

Tochie³

et al. 2019

BMJ Open

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IntroductionIn recent years, a hypothesis has been raised that people with tuberculosis are at risk for developing venous thromboembolism (VTE). However, much remains to be understood about the interplay between VTE and tuberculosis. Therefore, through a global systematic review and meta-analysis, the current study aims at investigating the association between exposure to active tuberculosis and risk of VTE, and determining the prevalence and incidence of VTE in people with active tuberculosis.Methods and designWe will include cohort studies, case–control and cross-sectional studies performed among adults (>15 years) with active tuberculosis. EMBASE, Medline, Global Index Medicus and Web of Knowledge will be searched for relevant records published until 31 August 2019, without any language restriction. The review will be reported according to the Meta-analysis Of Observational Studies in Epidemiology guidelines. After screening of titles and abstracts, study selection, data extraction and risk of bias assessment; we shall assess the studies individually for clinical and statistical heterogeneity. Random-effect meta-analysis will be used to pool studies judged to be clinically homogenous. The Egger’s test and visual inspection of funnel plots will be used to assess publication bias. Results will be presented by country and region.Ethics and disseminationSince primary data are not collected in this study, ethical approval is not required. This review is expected to provide relevant data on the epidemiology of VTE in people with tuberculosis. The final report will be published in a peer-reviewed journal.PROSPERO registration numberCRD42019130347.

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Venous thrombotic events in patients admitted to a tuberculosis centre

Cited by 12 publications

References 11 publications

Risk of recurrent venous thromboembolism in patients with HIV infection: A nationwide cohort study

Risk of recurrent venous thromboembolism in patients with HIV infection: A nationwide cohort study

Venous Thromboembolic Disease in Chronic Inflammatory Lung Diseases: Knowns and Unknowns

Epidemiology of venous thromboembolism in people with active tuberculosis: a systematic review and meta-analysis protocol

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