Venous thromboembolism: risk factors, biomarkers, and treatment.
Venous thromboembolism: risk factors, biomarkers, and treatment.
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静脉血栓栓塞：危险因素、生物标志物和治疗。
DOI：
10.1161/atvbaha.109.184580
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发表时间：
2009
期刊：
影响因子：
--
通讯作者：
Mackman,Nigel
中科院分区：
文献类型：
--
作者：
Wolberg,AlisaS;Mackman,Nigel
Biology focused on DVT. It is estimated that 2 million Americans per year develop DVT, which is associated with life-threatening pulmonary embolism (PE). DVT and PE are collectively termed venous thromboembolism (VTE). Despite the large number of cases, a survey conducted by the American Public Health Association in 2002 found that 74% of Americans were unaware of venous thrombosis. 1 The risk of VTE increases with thrombophilias, age, pregnancy, and comorbidities, including cancer and antiphospholipid syndrome (APS). It has not yet been determined whether similar mechanisms lead to VTE in each of these disorders. The articles in this issue describe current research into disorders associated with increased VTE risk, including potential pathophysiologic mechanisms, treatment of these clinical situations, and a review on biomarkers for the detection and prevention of VTE. The first article by Zhu et al, 2 entitled “Venous Thromboembolism: Risk Factors for Recurrence,” summarizes our current knowledge of the risk factors for recurrent VTE. This is an important issue because they influence the intensity and duration of anticoagulation therapy in different patients. The authors point out that VTE should be considered a chronic rather than acute illness because resolution of venous clots may take several weeks to months. These patients may also develop postthrombotic syndrome. They conclude that more studies are required to establish good biomarkers that predict VTE in the different patient populations. An original article in this series by Jang and colleagues, 3 entitled “Metabolic Syndrome Is Associated With Venous Thromboembolism in the Korean Population,” reports findings on a case-controlled study. Metabolic syndrome (MS) is a cluster of pathologies (abdominal obesity, hypertension, insulin resistance, dyslipidemia, and low HDL) that has previously been linked to atherosclerotic risk in several groups. However, the association between MS and VTE has only previously been reported in whites. The prevalence of MS in VTE patients in the Korean population compared to healthy controls strongly implicates this disorder in the etiology of idiopathic VTE in this population. However, the broader implications of this work stem from observations of the increase in incidences of both MS and VTE in the general population. MS may be a common pathogenic mechanism for the development of VTE, representing an important facet in the identification of patients at risk for VTE, as well as in studies into the causes and prevention of VTE. Cancer patients account for as many as 20% of the total burden of VTE in the general population. The article by Sousou and Khorana, 4 entitled “New Insights Into Cancer-Associated Thrombosis,” summarizes current thinking about risk factors and pathological mechanisms contributing to VTE in cancer patients. Considerable effort has focused on
