Risk Factors for Venous Thromboembolism in the Community

社区静脉血栓栓塞的危险因素

• 批准号: 9259808
• 负责人: ANEEL ARJUN ASHRANI
• 金额: $ 69.47万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-04-01 至 2020-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9259808
• 关键词: Acute; Address; Antigens; Back; Biological Markers; Blood; Blood flow; Caliber; Cancer Patient; Catheters; Centers for Disease Control and Prevention (U.S.); Cessation of life; Characteristics; Clinic; Clinical Research; Cohort Studies; Communities; Complication; County; Data; Deep Vein Thrombosis; Development; Disease; Epidemiology; Event; Exposure to; Family; Fracture; Funding; General Population; Genetic Variation; Goals; Health; Health Care Research; Heart; Heritability; Hospitalization; Hypotension; Incidence; Individual; Inguinal region; Joints; Knee; Knowledge; Leg; Lung; Malignant Neoplasms; Medical; Medical Records; Modeling; Nursing Homes; Operative Surgical Procedures; Pacemakers; Patients; Perioperative Nursing; Persons; Plasma; Population; Population Attributable Risks; Predictive Value; Prevalence; Prevention; Probability; Prophylactic treatment; Prothrombin; Public Health; Public Policy; Publishing; Pulmonary Embolism; Pulmonary artery structure; Recurrence; Resources; Right atrial structure; Right ventricular structure; Risk; Risk Factors; Site; Stroke; Structure of superficial vein; Sudden Death; Surgeon; Surveillance Program; Thromboembolism; Thromboplastin; Thrombosis; Thumb structure; Time; Tissues; Total Hip Replacement; Trauma; Travel; United States; Validation; Venous; Work; case control; chemotherapy; clinical practice; cohort; cost effective; deep vein; factor V Leiden; high risk; improved; knee replacement arthroplasty; leg paresis; neoplasm registry; nervous system disorder; precision medicine; prevent; public health relevance; tool; trend

 DESCRIPTION (provided by applicant): Venous thromboembolism (VTE) is a major health problem. The recent Surgeon General's Call to Action identified the "reasons for the persistent occurrence of VTE" as critical barriers to progress in the field. This project will address this question at the population level and shift clinical practice paradigms for primary and secondary VTE prevention by development and validating risk prediction tools to target specific subsets of high VTE-risk individuals. Our specific aims will address current gaps in knowledge by: (Aim 1) estimating (1a) secular trends in (i) VTE incidence and attack (incident and recurrent VTE) rates, (ii) prevalence and (iii) population attributable risk for each VTE risk factor, and (1b) estimating (i) transition probabilities in a multi-state model for incident and recurrent VTE and death after VTE and (ii) trends in survival after VTE to help inform public policy; (Aim 2) derivin and validating an overall VTE recurrence prediction score, including germline genetic variation (F5 rs6025, F2 rs1799963, ABO rs8176719); and (Aim 3) deriving and validating risk and prediction scores for (a) incident and (b) recurrent VTE among active cancer patients, respectively, including plasma biomarkers, germline genetic variation, and cancer tissue procoagulant (tissue factor) antigen expression for both scores. We will use data from previously completed case-control and case-cohort studies to derive the risk and prediction scores, and the longitudinal resources of the Rochester Epidemiology Project and the Mayo Clinic Cancer Registry to perform cohort studies of the entire population of Olmsted County and a large cohort of active cancer patients, respectively, for validation of the scores. The ability t identify high-risk subsets of individuals within: a) the general population (Aim 1), b) those with an incident VTE (aim 2), and c) those with active cancer (Aim 3) will facilitate targeted primary and secondary VTE prevention in a cost-effective and safe manner.

 描述(由申请人提供)：静脉血栓栓塞症(VTE)是一个主要的健康问题。最近卫生局局长的行动呼吁将“持续发生静脉血栓栓塞症的原因”确定为在该领域取得进展的关键障碍。该项目将在人群层面解决这一问题，并通过开发和验证风险预测工具来针对特定的VTE高危人群，转变初级和二级VTE预防的临床实践范式。我们的具体目标将通过：(目标1)评估(1a)VTE发病率和发作(事件和复发VTE)率的长期趋势，(Ii)患病率和(Iii)每个VTE风险因素的人群归因风险，以及(1b)估计(I)事件和复发VTE以及VTE后死亡的多态模型中的转移概率，以及(Ii)VTE后生存趋势，以帮助为公共政策提供信息；(目标2)推导和验证整体VTE复发预测分数，包括胚系遗传变异(F5 rs6025，F2 rs1799963，ABO rs8176719)；以及(目的3)分别推导和验证活动癌症患者中(A)事件和(B)复发VTE的风险和预测分数，包括这两个分数的血浆生物标记物、生殖系遗传变异和癌组织促凝血剂(组织因子)抗原表达。我们将使用之前完成的病例对照和病例队列研究的数据来得出风险和预测分数，并利用罗切斯特流行病学项目和梅奥诊所癌症登记中心的纵向资源分别对奥姆斯特县的整个人口和大量活跃的癌症患者进行队列研究，以验证分数。能够识别以下人群中的高危人群：a)普通人群(目标1)，b)发生静脉血栓栓塞者(目标2)，以及c)癌症活动性患者(目标3)将以具有成本效益和安全的方式促进有针对性的一级和二级静脉血栓栓塞症预防。