Arterial cardiovascular risk factors and venous thrombosis: results from a population-based, prospective study (the HUNT 2)
Arterial cardiovascular risk factors and venous thrombosis: results from a population-based, prospective study (the HUNT 2)
复制标题
DOI：
10.3324/haematol.2009.011866
复制
发表时间：
2010-01-01
期刊：
影响因子：
--
通讯作者：
Hammerstrom, Jens
中科院分区：
文献类型：
--
作者：
Quist-Paulsen, Petter;Naess, Inger Anne;Hammerstrom, Jens
背景 对于静脉血栓形成患者心肌梗塞和中风风险增加的解释尚不清楚。本研究的目的是调查动脉心血管疾病的危险因素是否也会增加静脉血栓形成的风险。 设计和方法从一项基于人群的巢式病例队列研究（HUNT 2 研究）中确定了首次发生静脉血栓形成的病例 (n=515) 和匹配对照 (n=1,505)，该研究包括 71% (n=66,140) 的成年居民。 挪威北特伦德拉格县。结果与 C 反应蛋白浓度最低五分位数的受试者相比，C 反应蛋白浓度最高五分位数的受试者的静脉血栓形成比值比为 1.6（95% 置信区间：1.2-2.2）。这种关联在血液采样后一年内经历静脉血栓形成的受试者中最为明显，最高五分位参与者的风险比最低五分位参与者的风险增加了三倍。与没有阳性家族史相比，一级亲属在 60 岁之前患有心肌梗死与静脉血栓形成呈正相关[比值比 1.3（95% 置信区间：1.1-1.6）]。与血压处于最低五分之一的受试者相比，血压处于最高五分之一的受试者发生静脉血栓形成的风险只有一半。静脉血栓形成的风险与总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、甘油三酯、葡萄糖或吸烟之间没有关联。我们证实了肥胖与静脉血栓形成之间的正相关性。结论C反应蛋白和心肌梗死家族史与随后的静脉血栓形成呈正相关。血压与静脉血栓形成呈负相关。这些发现应通过进一步调查得到证实。
BackgroundAn explanation for the increased risk of myocardial infarction and stroke in patients with venous thrombosis is lacking. The objective of this study was to investigate whether risk factors for arterial cardiovascular disease also increase the risk of venous thrombosis.Design and MethodsCases who had a first venous thrombosis (n=515) and matched controls (n=1,505) were identified from a population-based, nested, case-cohort study (the HUNT 2 study) comprising 71% (n=66,140) of the adult residents of Nord-Trondelag County in Norway.Results The age- and sex-adjusted odds ratio of venous thrombosis for subjects with concentrations of C-reactive protein in the highest quintile was 1.6 (95% confidence interval: 1.2-2.2) compared to subjects with C-reactive protein in the lowest quintile. This association was strongest in subjects who experienced venous thrombosis within a year after blood sampling with a three-fold increased risk of participants in the highest versus the lowest quintile. Having first degree relatives who had a myocardial infarction before the age of 60 years was positively associated with venous thrombosis compared to not having a positive family history [odds ratio 1.3 (95% confidence interval: 1.1-1.6)]. Subjects with blood pressure in the highest quintile had half the risk of developing venous thrombosis compared to subjects whose blood pressure was in the lowest quintile. There were no associations between the risk of venous thrombosis and total cholesterol, low density lipoprotein-cholesterol, high density lipoprotein-cholesterol, triglycerides, glucose or smoking. We confirmed the positive association between obesity and venous thrombosis.ConclusionsC-reactive protein and a family history of myocardial infarction were positively associated with subsequent venous thrombosis. Blood pressure was inversely correlated to venous thrombosis. These findings should be confirmed by further investigations.