Lifetime Risk of Venous Thromboembolism in Two Cohort Studies
Lifetime Risk of Venous Thromboembolism in Two Cohort Studies
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DOI：
10.1016/j.amjmed.2015.10.014
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发表时间：
2016-03-01
影响因子：
5.9
通讯作者：
Folsom, Aaron R.
中科院分区：
文献类型：
--
作者：
Bell, Elizabeth J.;Lutsey, Pamela L.;Folsom, Aaron R.
背景技术背景：提高公众对静脉血栓栓塞的认识可能是优化静脉血栓栓塞预防和治疗的重要下一步。“终生风险”是一种易于解释的风险信息表述方式。因此，我们试图计算静脉血栓栓塞的终生风险（深静脉血栓形成或肺栓塞）使用来自2个大型前瞻性队列研究的数据：心血管健康研究（CHS）和社区动脉粥样硬化风险（ARIC）研究。我们跟踪了ARIC中45-64岁的参与者（n = 14，185）和>= 65在CHS（n = 5414）基线访视时（ARIC为1987-1989年，CHS为1989-1990年和1992-1993年）发生静脉血栓栓塞（ARIC至2011年n = 728，CHS至2001年n = 172）。我们估计终身风险和95%的置信区间的事件静脉血栓栓塞使用修改后的Kaplan-Meier方法，占竞争风险的其他causes.RESULTS死亡：在45岁时，剩余的终身风险静脉血栓栓塞在ARIC是8.1%（95%的置信区间，7.1-8.7）。高风险组是非裔美国人（11.5%的终生风险），肥胖（10.9%），因子V Leiden杂合子（17.1%）或镰状细胞性状或疾病（18.2%）。终生风险估计不同的队列，这些差异的解释静脉血栓栓塞ascertainment.CONCLUSIONS：至少有1在12个中年人将开发静脉血栓栓塞在其剩余的生命周期的时间段的差异。这种终生风险的估计可能有助于提高对静脉血栓栓塞的认识，并指导临床和政策层面的决策。(C)2016 Elsevier Inc. All rights reserved.
BACKGROUND: Greater public awareness of venous thromboembolism may be an important next step for optimizing venous thromboembolism prevention and treatment. "Lifetime risk" is an easily interpretable way of presenting risk information. Therefore, we sought to calculate the lifetime risk of venous thromboembolism (deep vein thrombosis or pulmonary embolism) using data from 2 large, prospective cohort studies: the Cardiovascular Health Study (CHS) and the Atherosclerosis Risk in Communities (ARIC) study.METHODS: We followed participants aged 45-64 years in ARIC (n = 14,185) and >= 65 in CHS (n = 5414) at baseline visits (1987-1989 in ARIC, 1989-1990 and 1992-1993 in CHS) for incident venous thromboembolism (n = 728 in ARIC through 2011 and n = 172 in CHS through 2001). We estimated lifetime risks and 95% confidence intervals of incident venous thromboembolism using a modified Kaplan-Meier method, accounting for the competing risk of death from other causes.RESULTS: At age 45 years, the remaining lifetime risk of venous thromboembolism in ARIC was 8.1% (95% confidence interval, 7.1-8.7). High-risk groups were African Americans (11.5% lifetime risk), those with obesity (10.9%), heterozygous for the factor V Leiden (17.1%), or with sickle cell trait or disease (18.2%). Lifetime risk estimates differed by cohort; these differences were explained by differences in time period of venous thromboembolism ascertainment.CONCLUSIONS: At least 1 in 12 middle-aged adults will develop venous thromboembolism in their remaining lifetime. This estimate of lifetime risk may be useful to promote awareness of venous thromboembolism and guide decisions at both clinical and policy levels. (C) 2016 Elsevier Inc. All rights reserved.