Association between thyroid dysfunction and venous thromboembolism: A systematic review and meta-analysis

Wang, Yunmeng; Ding, ChaoWei; Guo, Chuangxin; Wang, Jingru; Liu, Suyun

doi:10.1097/md.0000000000033301

Cited by 5 publications

(4 citation statements)

References 38 publications

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“…A large population study of 53,418 patients registers that in patients with hyperthyroidism, the risk of pulmonary embolism is 2.31 times higher than the control group during a 5-year follow-up after adjusting for confounding factors [ 40 ]. A meta-analysis that included 15 studies up until October 2022 found an increased risk of venous thromboembolism (VTE) even in patients with subclinical hyperthyroidism (OR 1.33, 95% CI: 1.29–1.38) [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…The significance of the data on hyperthyroidism as a probable prothrombotic condition has not been sufficiently implemented in clinical practice, nor are large studies consistent in asserting the association between elevated thyroid hormone values and thrombotic events [ 1 , 2 ]. The results of a new meta-analysis and the findings of other authors indicate that the prothrombotic milieu induced by hyperthyroidism contributes to the increased risk of venous thromboembolism (OR 1.322, 95% CI: 1.278–1.368) [ 1 ]. It is believed that the emergence of a prothrombotic (hypercoagulable and hypofibrinolytic) state in hyperthyroidism is significantly contributed to by an elevated level of factor VIII (FVIII), von Willebrand factor (vWF), fibrinogen, and plasminogen activator inhibitor-1 (PAI-1), the level of which increases gradually with the level of thyroid hormones [ 2 , 3 , 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

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The Influence of Hyperthyroidism on the Coagulation and on the Risk of Thrombosis

Antonijevic,

Matic,

Beleslin

et al. 2024

JCM

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Introduction: Apart from the well-known fact that hyperthyroidism induces multiple prothrombotic disorders, there is no consensus in clinical practice as to the impact of hyperthyroidism on the risk of thrombosis. The aim of this study was to examine the various hemostatic and immunologic parameters in patients with hyperthyroidism. Methods: Our study consists of a total of 200 patients comprised of 64 hyperthyroid patients, 68 hypothyroid patients, and 68 euthyroid controls. Patient thyroid status was determined with standard tests. Detailed hemostatic parameters and cardiolipin antibodies of each patient were determined. Results: The values of factor VIII (FVIII), the Von Willebrand factor (vWF), fibrinogen, plasminogen activator inhibitor-1 (PAI-1), and anticardiolipin antibodies of the IgM class were significantly higher in the hyperthyroid patients than in the hypothyroid patients and euthyroid controls. The rate of thromboembolic manifestations was much higher in hyperthyroid patients (6.25%) than in hypo-thyroid patients (2.9%) and euthyroid controls (1.4%). Among hyperthyroid patients with an FVIII value of ≥1.50 U/mL, thrombosis was recorded in 8.3%, while in hyperthyroid patients with FVIII value ≤ 1.50 U/mL the occurrence of thrombosis was not recorded. The incidence of atrial fibrillation (AF) was significantly higher (8.3%) in the hyperthyroid patients compared to the hypothyroid patients (1.5%) and euthyroid controls (0%). Conclusions: High levels of FVIII, vWF, fibrinogen, PAI-1, and anticardiolipin antibodies along with other hemostatic factors contribute to the presence of a hypercoaguable state in patients with hyperthyroidism. The risk of occurrence of thrombotic complications is especially pronounced in patients with a level of FVIII exceeding 150% and positive anticardiolipin antibodies of the IgM class. Patients with AF are at particularly high risk of thrombotic complications due to a hyperthyroid prothrombotic milieu.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Influence of Hyperthyroidism on the Coagulation and on the Risk of Thrombosis

Antonijevic,

Matic,

Beleslin

et al. 2024

JCM

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“…19 Several NCDs, but not all, included in the multimorbidity study by Barnett et al 14 have been associated with VTE. [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] For some associations between NCDs and VTE, the associations are bidirectional, [36][37][38] for example, atherosclerotic disease and atrial fibrillation, but for most NCDs, the association with VTE is unidirectional. [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] However, to the best of our knowledge, the association between multimorbidity and its severity (ie, number of NCDs) and VTE has not been studied.…”

Section: Open Accessmentioning

confidence: 99%

A hypothesis - generating Swedish extended national cross-sectional family study of multimorbidity severity and venous thromboembolism

et al. 2023

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ObjectivesVenous thromboembolism (VTE) is a common worldwide disease. The burden of multimorbidity, that is, two or more chronic diseases, has increased. Whether multimorbidity is associated with VTE risk remains to be studied. Our aim was to determine any association between multimorbidity and VTE and any possible shared familial susceptibility.DesignA nationwide extended cross-sectional hypothesis - generating family study between 1997 and 2015.SettingThe Swedish Multigeneration Register, the National Patient Register, the Total Population Register and the Swedish cause of death register were linked.Participants2 694 442 unique individuals were analysed for VTE and multimorbidity.Main outcomes and measuresMultimorbidity was determined by a counting method using 45 non-communicable diseases. Multimorbidity was defined by the occurrence of ≥2 diseases. A multimorbidity score was constructed defined by 0, 1, 2, 3, 4 or 5 or more diseases.ResultsSixteen percent (n=440 742) of the study population was multimorbid. Of the multimorbid patients, 58% were females. There was an association between multimorbidity and VTE. The adjusted odds ratio (OR) for VTE in individuals with multimorbidity (2 ≥ diagnoses) was 3.16 (95% CI: 3.06 to 3.27) compared with individuals without multimorbidity. There was an association between number of diseases and VTE. The adjusted OR was 1.94 (95% CI: 1.86 to 2.02) for one disease, 2.93 (95% CI: 2.80 to 3.08) for two diseases, 4.07 (95% CI: 3.85 to 4.31) for three diseases, 5.46 (95% CI: 5.10 to 5.85) for four diseases and 9.08 (95% CI: 8.56 to 9.64) for 5 ≥ diseases. The association between multimorbidity and VTE was stronger in males OR 3.45 (3.29 to 3.62) than in females OR 2.91 (2.77 to 3.04). There were significant but mostly weak familial associations between multimorbidity in relatives and VTE.ConclusionsIncreasing multimorbidity exhibits a strong and increasing association with VTE. Familial associations suggest a weak shared familial susceptibility. The association between multimorbidity and VTE suggests that future cohort studies where multimorbidity is used to predict VTE might be worthwhile.

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Multimorbidity disease clusters are associated with venous thromboembolism: an extended cross-sectional national study

Ahrén,

Pirouzifard,

Holmquist

et al. 2024

J Thromb Thrombolysis

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Multimorbidity, i.e., two or more non-communicable diseases (NCDs), is an escalating challenge for society. Venous thromboembolism (VTE) is a common cardiovascular disease and it is unknown which multimorbidity clusters associates with VTE. Our aim was to examine the association between different common disease clusters of multimorbidity and VTE. The study is an extended (1997–2015) cross-sectional Swedish study using the National Patient Register and the Multigeneration Register. A total of 2,694,442 Swedish-born individuals were included in the study. Multimorbidity was defined by 45 NCDs. A principal component analysis (PCA) identified multimorbidity disease clusters. Odds ratios (OR) for VTE were calculated for the different multimorbidity disease clusters. There were 16% (n = 440,742) of multimorbid individuals in the study population. Forty-four of the individual 45 NCDs were associated with VTE. The PCA analysis identified nine multimorbidity disease clusters, F1-F9. Seven of these multimorbidity clusters were associated with VTE. The adjusted OR for VTE in the multimorbid patients was for the first three clusters: F1 (cardiometabolic diseases) 3.44 (95%CI 3.24–3.65), F2 (mental disorders) 2.25 (95%CI 2.14–2.37) and F3 (digestive system diseases) 4.35 (95%CI 3.63–5.22). There was an association between multimorbidity severity and OR for VTE. For instance, the occurrence of at least five diseases was in F1 and F2 associated with ORs for VTE: 8.17 (95%CI 6.32–10.55) and 6.31 (95%CI 4.34–9.17), respectively. In this nationwide study we have shown a strong association between VTE and different multimorbidity disease clusters that might be useful for VTE prediction. Graphical abstract

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Association between thyroid dysfunction and venous thromboembolism: A systematic review and meta-analysis

Cited by 5 publications

References 38 publications

The Influence of Hyperthyroidism on the Coagulation and on the Risk of Thrombosis

The Influence of Hyperthyroidism on the Coagulation and on the Risk of Thrombosis

A hypothesis - generating Swedish extended national cross-sectional family study of multimorbidity severity and venous thromboembolism

Multimorbidity disease clusters are associated with venous thromboembolism: an extended cross-sectional national study

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