Hematologic variables and venous thrombosis: red cell distribution width and blood monocyte count are associated with an increased risk

Abstract

Odds ratios and their 95% confidence intervals (95% CI) were cal- open-access paper. doi:10.3324/haematol.2013 Recent studies suggest that leukocytes and erythrocytes play a role in coagulation. However, whether leukocytes, erythrocytes and other hematologic variables are associated with risk of venous thrombosis is not well known. To study this, we used data from 2473 patients with venous thrombosis and 2935 controls. The variables assessed were: total leukocytes, granulocytes, lymphocytes, monocytes, hematocrit, hemoglobin, erythrocytes and red cell indices (mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration and red cell distribution width). We found a strong dose-response relation for higher red cell distribution width and monocyte count with risk of venous thrombosis, with odds ratios of 3.1 (95% confidence interval, 2.0-4.8) and 2.8 (95% confidence interval, 1.3-5.8), respectively, after adjustment for age, sex, C-reactive protein level, malignancy and co-morbidities. Monocyte count and red cell distribution width were associated with venous thrombosis even within reference ranges. A low monocyte count (<0.12x10 9 /L) was associated with a lower risk of venous thrombosis after full adjustment (odds ratios 0.6; 95% confidence interval, 0.4-0.8). In summary, high red cell distribution width and blood monocyte count, two parameters that are inexpensive and easily obtainable, were clearly associated with an increased risk of venous thrombosis. Future studies should evaluate the underlying mechanism and the use of these variables in prediction models for first and recurrent thrombosis. ©2013 Ferrata Storti Foundation. This is an Hematologic variables and venous thrombosis: red cell distribution width and blood monocyte count are associated with an increased risk

The Relationship between Leukocyte Counts and Venous Thromboembolism: Results from RETROVE Study

“…These results confirm and extend what has been reported previously in other studies [11,12]. However in our study we found a highly statistically significance association of monocytes and previous VTE (OR 2.47 and p value 2.49 ×10 -4 ).…”

“…It is obvious that our results do not exclude the possibility that there is a relationship between other types of leukocytes and thrombosis. We don't know if there is a causal relationship between high monocyte levels and the disease because our sample has been taken after the thrombotic episode, but, our findings, are in line of Tromsø and MEGA studies [11,12] and they support that high monocyte counts are in association with past VTE. We believe that our results provide a firm foundation for additional studies and they suggest that a high monocyte count are related with VTE risk and could be a useful parameter in future prediction models.…”

“…Leukocytes play a role in coagulation, but it is not clear if they play a role in the risk of VTE [12]. In our sample, patients had increased counts of neutrophils and monocytes.…”

“…In support of this hypothesis, patient monocytes, expressed higher levels of TF protein than in the controls. The MEGA study [12] (a case-control study) found that a high peripheral monocyte count (above 0.55 × 10 9 /L), even within the reference range, was associated with DVT in a dose-response manner: odds ratio (OR) 2.8 and 95% confidence interval [CI], 1.3-5.8.…”

Red Cell Distribution Width Has a Predictable Value for Differentiation of Provoked and Unprovoked Venous Thromboembolism

“…The ROC analysis showed that the best cut-off value is 13.6 % for RDW and it has a predictive value for differentiation. In studies performed by Rezende et al [24], Cay et al [25], and Ozsu et al [26], they found that high RDW level was associated with VTE and it was also an independent risk factor for mortality and VTE diagnosis. Zorlu et al [27] found that RDW seems to aid in the risk stratification of patients with acute PE with RDW [14.6.…”