Cigarette smoking and the risk of venous thromboembolism: The Tromsø Study

Enga, Kristin F.; Brækkan, Sigrid Kufaas; Hansen-Krone, Ida Johanne; Cessie, Saskia le; Rosendaal, Frits R.; Hansen, John‐Bjarne

doi:10.1111/j.1538-7836.2012.04880.x

Cited by 88 publications

(76 citation statements)

References 34 publications

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“…Any association between COPD and risk of VTE may be affected by confounders. Smoking is the leading cause of COPD [33] and is also associated with risk of VTE in some [34,35], but not all [36,37], cohort studies. In our study, the impact of COPD on the risk of VTE remained unchanged after adjustment for smoking.…”

Section: Discussionmentioning

confidence: 99%

COPD and risk of venous thromboembolism and mortality in a general population

et al. 2015

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The relationship between chronic obstructive pulmonary disease (COPD) and risk of venous thromboembolism (VTE) has been scarcely studied in the general population. We aimed to investigate the association between COPD and risk of VTE and mortality in a population-based cohort.Spirometry was conducted in 8646 males and females, participating in the fifth (2001-02) and sixth (2007-08) surveys of the Tromsø Study. Incident VTE events during follow-up were registered from the date of inclusion to December 31, 2011. Cox-regression models with COPD stages and confounders as time varying covariates were used to calculate hazard ratios with 95% confidence intervals for VTE and all-cause mortality.During a median follow-up of 6.2 years, 215 subjects developed VTE. Subjects with COPD stage III/IV had a two-fold higher risk of secondary VTE compared to subjects with normal airflow (HR 2.05, 95% CI 1.02-4.10). COPD patients, particularly those with stage III/IV disease, with VTE had a higher mortality rate than COPD patients without VTE (50.2% versus 5.6% per year).Our findings suggest that patients with severe COPD may have increased risk of secondary VTE, and that COPD patients with VTE have a higher mortality rate than COPD patients without VTE. @ERSpublications Patients with severe COPD may have increased risk of VTE: VTE is associated with a worse prognosis in COPD patients

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Section: Discussionmentioning

confidence: 99%

COPD and risk of venous thromboembolism and mortality in a general population

et al. 2015

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“…Although literature shows a 2-to 4-fold increase in thrombotic risk of hormonal therapy, we found no association with VTE, mainly due to the low prevalence (1.83% in VTE and 5.07% in women with VTE) and thus, we did not detail the analysis (according to the dose, route of administration) [8]. Smoking may represent a weak risk factor for DVT, especially in studies considering VTE events as the only outcome [19]; we found smoking to be relatively frequent in VTE (32.9%), but not enough to be independently associated with thrombotic risk. Family history is an independent risk factor for VTE, reflecting a hereditary thrombophilia [20].…”

Section: Discussionmentioning

confidence: 70%

Risk factors in venous thromboembolism in hospitalized patients

Andercou¹

2014

Open Medicine

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AbstractVenous thromboembolism (VTE) causes considerable morbidity and mortality. About half of all VTE cases in adults are related to recent hospitalization, in spite of the clinical guidelines regarding prophylaxis. We aimed to assess the frequency and the independent risk factors in VTE in hospitalized patients, and to compare the risk factors in medical versus surgical cases. A case-control study consisting of 732 patients (382 with VTE and 350 controls) was designed. At least one risk factor was found in 90.31% of VTE cases; more than half of the patients presented multiple risk factors, associated with a double risk comparatively to the intervention of only one factor. A similar distribution of the risk factors was found in both medical and surgical patients, except for congestive cardiac failure (predominant in medical cases) and respectively, varicose veins, previous episode of VTE and cancer (predominant in surgical VTE patients). The independent risk factors in VTE were the following: previous episode of VTE, obesity, chronic obstructive pulmonary disease, congestive cardiac failure, varicose veins and cancer. The study shows the importance of the risk factors in VTE and the need to detect hospitalized patients at risk in both medical and surgical cases.

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“…The Tromsø study identifi ed an increased risk of 1.5 of total VTE and 1.8 in provoked VTE in heavy smokers (>20 pack-years). 15 Heavy smokers showed a higher incidence of VTE compared to nonsmokers or moderate smokers when combined with the heterozygous Factor V Leiden mutation. 16 Smoking may have contributed to our patient's fi rst VTE (2008), but it could not have been a contributing factor with his second VTE because he quit smoking in 2008.…”

Section: Discussionmentioning

confidence: 93%

Recurrent Venous Thromboembolism in a Patient with Heterozygous Factor V Leiden Mutation

2014

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Objective: To report a patient case identifying risk for recurrent venous thromboembolism (VTE) associated with heterozygous Factor V Leiden mutation. Case Summary: A 54-year-old Caucasian male was diagnosed with heterozygous Factor V Leiden mutation in 2008 after experiencing a deep vein thrombosis (DVT) and bilateral pulmonary embolism. The patient was treated appropriately and started on anticoagulation therapy with warfarin through an anticoagulation management clinic. After approximately 17 months of warfarin therapy without incident, warfarin was discontinued. Within 2 months after discontinuation of anticoagulation therapy, the patient experienced his second DVT and left pulmonary artery embolus. Discussion: The risk of recurrent venous thromboembolism (VTE) in patients with heterozygous Factor V Leiden mutation is documented as an approximate 1.4-fold increase compared to patients without thrombophilia. However, the risk increases dramatically when nonreversible (age) or reversible risk factors (obesity, smoking, and long air fl ights) are present in this population. Conclusion: Based on recent literature, heterozygous Factor V Leiden mutation exponentially increases the risk of recurrent VTE, especially in the presence of other risk factors. Health care providers should complete a comprehensive review of the patients' other risk factors when deciding on duration of anticoagulation therapy for patients with positive heterozygous Factor V Leiden mutation. Even though thrombophilias may increase the risk of VTE, current literature states that thrombophilia should not be considered a major factor in determining the duration of anticoagulation therapy after VTE. The guidelines state that standard therapy (3 to 12 months) of anticoagulation is acceptable in the prevention of recurrent VTE in patients with thrombophilias including Factor V Leiden mutation. Key Words-heterozygous5 Our case report documents a patient with heterozygous V enous thromboembolism (VTE) is a major medical issue that results from a combination of genetic, acquired, and modifi able risk factors.1 Patients with VTE have a higher incidence of death compared to patients without VTE.2 Thrombophilias have been associated with an increased risk of fi rst and recurrent VTE, with Factor V Leiden mutation being the most common genetic risk factor.3 Factor V Leiden mutation occurs in 40% to 50% of cases of hereditary thrombophilia; only 3% to 8%

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Cigarette smoking and the risk of venous thromboembolism: The Tromsø Study

Cited by 88 publications

References 34 publications

COPD and risk of venous thromboembolism and mortality in a general population

COPD and risk of venous thromboembolism and mortality in a general population

Risk factors in venous thromboembolism in hospitalized patients

Recurrent Venous Thromboembolism in a Patient with Heterozygous Factor V Leiden Mutation

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