Journal of the Chinese Medical Association
Volume 70, Issue 3 , Pages 103-109, March 2007

Cardiovascular Diseases and the Risk of Venous Thromboembolism: A Hospital-based Case-control Study

  • Chen-Chang Yang

      Affiliations

    • Department of Environmental and Occupational Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • Division of Clinical Toxicology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • Corresponding Author InformationCorrespondence to: Dr Chen-Chang Yang, Division of Clinical Toxicology, Department of Medicine, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan, R.O.C.
    • ,
  • Chih-Chin Kao

      Affiliations

    • Division of Clinical Toxicology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.

Received 2 May 2006; accepted 22 December 2006.

Article Outline

Background

The effects of various cardiovascular diseases on the risk of venous thromboembolism (VTE) are not well defined. To gather more information, we performed a hospital-based case-control study to evaluate the effects of major cardiovascular diseases on the risk of VTE.

Methods

We identified all incident cases of VTE needing hospitalization and anticoagulant therapy between January 1990 and December 2002 in a large tertiary hospital. Each case was matched with up to 4 controls, randomly selected from inpatients who were not hospitalized due to any of the exposures, on age, sex, calendar time and veteran/nonveteran status.

Results

This study comprised 173 cases of VTE and 546 matched controls. The adjusted odds ratio (OR) of VTE was significant among patients with peripheral atherosclerotic diseases (OR 7.1, 95% confidence interval [CI] 1.4-34.4), and nondebilitating cerebrovascular diseases (OR 2.5, 95% CI 1.4-4.7). Other independent risk factors for VTE included a body mass index ≥ 25.0kg/m2 current estrogen use, a history of hyperlipidemia and varicose veins.

Conclusion

Peripheral atherosclerotic disease and nondebilitating cerebrovascular disease are important risk factors for VTE. Patients with these diseases should therefore be frequently evaluated for the possible coexistence of VTE and, if appropriate, should be given prophylaxis. Failure to take into account the potential confounding effects of these diseases may also result in an erroneous estimate of the effect of drug exposures on the risk of idiopathic VTE.

Key Words:  cardiovascular disease , confounding factors , pulmonary embolism , venous thrombosis

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References 

  1. Heit JA , Silverstein MD , Mohr DN , Petterson TM , O'Fallon WM , Melton LJ . Risk factors for deep vein thrombosis and pulmonary embolism . Arch Intern Med . 2000;160:809–815
  2. Kniffin WD , Baron JA , Barrett J , Birkmeyer JD , Anderson FA . The epidemiology of diagnosed pulmonary embolism and deep venous thrombosis in the elderly . Arch Intern Med . 1994;154:861–866
  3. Geerts WH, Pinea GF, Hett JA, Bergqvist D, Lassen MR, Colwell CW, et al. Prevention of venous thromboembolism. The Seventh ACCP Conference on Antithrombotic and Throm-botic Therapy . Chest . 2004;126:338S–400S
  4. Bosson JL, Labarere J, Sevestre MA, Belmin J, Beyssier L, Elias A, et al  Deep vein thrombosis in elderly patients hospitalized in subacute care facilities: a multicenter cross-sectional study of risk factors, prophylaxis, and prevalence . Arch Intern Med . 2003;163:2613–2618
  5. Alikhan R, Cohen AT, Combe S, Samama MM, Desjardins L, Eldor A, et al  Risk factors for venous thrombo-embolism in hospitalized patients with acute medical illness: analysis of the MEDENOX study . Arch Intern Med . 2004;164:963–968
  6. Black C , Kaye JA , Jick H . Clinical risk factors for venous throm-boembolus in users of the combined oral contraceptive pill . Br J Clin Pharmacol . 2002;53:637–640
  7. Cushman M, Tsai AW, White RH, Heckbert SR, Rosamond WD, Enright P, et al. Deep vein thrombosis and pulmonary embolism in two cohorts: the longitudinal investigation of throm-boembolism etiology . Am J Med . 2004;117:19–25
  8. Zornberg GL , Jick H . Antipsychotic drug use and risk of first-time idiopathic venous thromboembolism: a case-control study . Lancet . 2000;356:1219–1223
  9. Pérez-Gutthann S , Garcia Rodriguez LA , Castellsague J , Oliart AD . Hormone replacement therapy and risk of venous thrombo-embolism: population based case-control study . Br Med J . 1997;314:796–800
  10. Yang CC , Jick SS , Jick H . Statins and the risk of idiopathic venous thromboembolism . Br J Clin Pharmacol . 2002;53:101–105
  11. Grady D, Wenger NK, Herrington D, Khan S, Furberg C, Hunninghake D, et al  Postmenopausal hormone therapy increases risk for venous thromboembolic disease: the Heart and Estrogen/progestin Replacement Study . Ann Intern Med . 2000;132:689–696
  12. Lacut K, Oger E, Le Gal G, Couturaud F, Louis S, Leroyer C, et al. Statins but not fibrates are associated with a reduced risk of venous thromboembolism: a hospital-based case-control study . Fundam Clin Pharmacol . 2004;18:477–482
  13. Rosenson RS , Tangney CC . Antiatherothrombotic properties of statins: implication for cardiovascular event reduction . JAMA . 1998;279:1643–1650
  14. Daly E , Vessey MP , Hawkins MM , Carson JL , Gough P , Marsh S . Risk of venous thromboembolism in users of hormone replacement therapy . Lancet . 1996;348:977–980
  15. Ray JG , Tsuyuki RT , Anderson DR , Yeo EL , Laupacis A . Use of statins and the subsequent development of deep vein thrombosis . Arch Intern Med . 2001;161:1405–1410
  16. World Health Organization Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception  . Venous thromboembolic disease and combined oral contraceptives: results of international multicentre case-control study . Lancet . 1995;346:1575–1582
  17. Cogo A, Bernardi E, Pradoni P, Girolami B, Noventa F, Simioni P, et al. Acquired risk factors for deep-vein thrombosis in symptomatic outpatients . Arch Intern Med . 1994;154:164–168
  18. Libertiny G , Hands L . Deep venous thrombosis in peripheral vascular disease . Br J Surg . 1999;86:907–910
  19. Langhorne P, Stott DJ, Robertson L, MacDonald J, Jones L, McAlpine C, et al  Medical complications after stroke: a multicenter study . Stroke . 2000;31:1223–1229
  20. Kelly J , Rudd A , Lewis RR , Coshall C , Moody A , Hunt BJ . Venous thromboembolism after acute ischemic stroke: a prospective study using magnetic resonance direct thrombus imaging . Stroke . 2004;35:2320–2325
  21. Goldman MP , Fronek A . Anatomy and pathophysiology of varicose veins . J Dermatol Surg Oncol . 1989;15:138–145
  22. Kurz X, Lamping DL, Kahn SR, Baccaglini U, Zuccarelli F, Spreafico G, et al. Do varicose veins affect quality of life? Results of an international population-based study . J Vasc Surg . 2001;34:641–648
  23. Decousus H , Epinat M , Guillot K , Quenet S , Boissier C , Tardy B . Superficial vein thrombosis: risk factors, diagnosis, and treatment . Curr Opin Pulm Med . 2003;9:393–397
  24. Kawasaki T , Kambayashi JI , Aruyoshi H , Sakon M , Suehisa E , Monden M . Hypercholesterolemia as a risk factor for deep-vein thrombosis . Thromb Res . 1997;88:67–73
  25. Vaya A, Mira Y, Martinez M, Villa P, Ferrando F, Estelles A, et al  Biological risk factors for deep vein thrombosis . Clin Hemorheol Microcirc . 2002;26:41–53

PII: S1726-4901(09)70339-9

doi:10.1016/S1726-4901(09)70339-9

Journal of the Chinese Medical Association
Volume 70, Issue 3 , Pages 103-109, March 2007

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