Deep vein thrombosis and pulmonary embolism in two cohorts: the longitudinal investigation of thromboembolism etiology

Cushman, Mary; Tsai, Albert; White, Richard; Heckbert, Susan R.; Rosamond, Wayne D.; Enright, Paul; Folsom, Aaron R.

doi:10.1016/j.amjmed.2004.01.018

Cited by 770 publications

(685 citation statements)

References 25 publications

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“…Similar to findings in other studies, our findings revealed the absolute prevalence of VTE to be highest among older women (34-45 years of age), regardless of PCOS status. 3,4,6,7,26 Unexpectedly, however, we found that women 18-24 years of age had the highest likelihood of having a VTE diagnosis, meaning that the …”

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confidence: 54%

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

Okoroh

Hooper

Atrash

et al. 2012

American Journal of Obstetrics and Gynecology

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OBJECTIVE-We sought to determine prevalence and likelihood of venous thromboembolism (VTE) among women with and without polycystic ovary syndrome (PCOS). STUDY DESIGN-We performed a cross-sectional analysis using Thomson Reuters MarketScanCommercial databases for the years 2003 through 2008. The association between VTE and PCOS among women aged 18-45 years was assessed using age-stratified multivariable logistic regression models.RESULTS-Prevalence of VTE per 100,000 was 374.2 for PCOS women and 193.8 for women without PCOS. Compared with women without PCOS, those with PCOS were more likely to have VTE (adjusted odds ratio [aOR] 18-24 years, 3.26; 95% confidence interval [CI], 2.61-4.08; aOR 25-34 years, 2.39; 95% CI, 2.12-2.70; aOR 35-45 years, 2.05; 95% CI, 1.84-2.38). A protective association (odds ratio, 0.8; 95% CI, 0.73-0.98) with oral contraceptive use was noted for PCOS women.CONCLUSION-PCOS might be a predisposing condition for VTE, particularly among women aged 18-24 years. Oral contraceptive use might be protective. Keywordspolycystic ovary syndrome; prevalence; venous thromboembolism Venous thromboembolism (VTE) is a chronic condition that includes both deep vein thrombosis (DVT) and pulmonary embolism (PE). Initial presentation might be leg pain, tenderness, shortness of breath, or pleuritic chest pain, or there might be no symptoms. 1 VTE is the third most common cardiovascular disease-after myocardial infarction and stroke-among the general population. 2,3 The overall annual incidence of VTE is estimated © 2012 Mosby, Inc. All rights reserved.Reprints: Ekwutosi M. Okoroh, MD, Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Rd., Mailstop E64, Atlanta, GA 30333. Eokoroh@cdc.gov. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.The authors report no conflict of interest.Presented orally at the 60th Annual Epidemic Intelligence Service Conference, Atlanta, GA, April 11-15, 2011. HHS Public Access Author Manuscript Author ManuscriptAuthor Manuscript Author Manuscript to be 1-2 per 1000 adults per year. [4][5][6][7] These incident estimates, however, might not represent the entire population because VTE incidence differs by age and race, and slightly by sex. VTE is a multifactorial disease with both inherited and acquired risk factors. In 26-47% of first-time VTE cases, the etiology is unknown 4,5,8 ; a possible predisposing condition not yet assessed is polycystic ovary syndrome (PCOS).PCOS is the most common endocrine disorder affecting women of reproductive age. Estimates of its prevalence vary and range from 4-6%. 9-12 Its exact etiology is unknown, but it is characterized by a heterogeneous presentation of hyperandrogenism, ovulatory dysfunction, and polycystic ovaries. 13 PCOS is also associated with insulin-induced elevations of plasminogen activator inhibitor (P...

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confidence: 54%

“…[4][5][6][7] These incident estimates, however, might not represent the entire population because VTE incidence differs by age and race, and slightly by sex. VTE is a multifactorial disease with both inherited and acquired risk factors.…”

Section: Author Manuscript Author Manuscriptmentioning

confidence: 99%

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

Okoroh

Hooper

Atrash

et al. 2012

American Journal of Obstetrics and Gynecology

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“…The LITE is a prospective study that combined two U.S. cohorts, the Cardiovascular Health Study (CHS) and the Atherosclerosis Risk in Communities (ARIC) study [22]. Both population-based studies examined risk factors at baseline and subsequent development of cardiovascular diseases in six communities.…”

Section: Subjectsmentioning

confidence: 99%

“…A total of 548 cases of VT were validated using standardized criteria from baseline to 2002 as previously described [22]. Each study maintained contact with all participants and identified all hospitalizations.…”

Section: Subjectsmentioning

confidence: 99%

Associations of the β-fibrinogen Hae III and factor XIII Val34Leu gene variants with venous thrombosis

Cushman

Cornell

Folsom

et al. 2007

Thrombosis Research

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“…Overall, cancer is responsible for up to 25% of all incident VTE cases[2, 5,6].The aetiology of cancer associated VTE is heterogeneous, and pathogenic mechanisms include tumour induced hypercoagulability, vascular injury caused by the tumour, chemotherapy or surgery, long term central venous catheters, venous stasis among bedridden patients, and tumour-dependent compression of the venous circulation [7].In subjects with cancer, a VTE event is associated with more frequent and prolonged hospital stays [8],more severe treatment complications [9],increased risk of recurrence [9,10] and shortened life-expectancy compared to cancer patients without VTE [11,12].…”

Section: Introductionmentioning

confidence: 99%

The increased risk of venous thromboembolism by advancing age cannot be attributed to the higher incidence of cancer in the elderly: the Tromsø study

et al. 2014

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Whether the high incidence of venous thromboembolism (VTE) in the elderly can be attributed to cancer is not wellstudied. We assessed the impact of cancer on risk of VTE in young, middle-aged and elderly. 26,094 subjects without a history of cancer or VTE were recruited from the Tromsø study. Incident cancer (n=2,290) and VTE (n=531) were recorded from baseline (1994-95) through December 31st, 2009. Cox regression with cancer as time-varying exposure was used to calculate hazard ratios with 95% confidence intervals (CI). Overt cancer was associated with a 5-fold (95%CI: 4.3, 6.7) increased risk of VTE, with an age-dependent gradient from 26-fold (95 %CI: 12.1, 56.5) increased in the young, 9-fold (95% CI: 6.6, 12.7) increased in the middleaged, and 3-fold (95 % CI: 2.5, 4.5) increased risk in the elderly. The population attributable risks were 14%, 27% and 18%, respectively. Conclusion: The relative risk of VTE by cancer were higher in young compared to elderly subjects, but the proportion of VTEs in the population due to cancer did not differ much across age groups. Our findings indicate that the increased risk of VTE by advancing age cannot be attributed to higher incidence of cancer in the elderly.

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Deep vein thrombosis and pulmonary embolism in two cohorts: the longitudinal investigation of thromboembolism etiology

Cited by 770 publications

References 25 publications

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

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

Associations of the β-fibrinogen Hae III and factor XIII Val34Leu gene variants with venous thrombosis

The increased risk of venous thromboembolism by advancing age cannot be attributed to the higher incidence of cancer in the elderly: the Tromsø study

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