Deep vein thrombosis and pulmonary embolism in two cohorts: the longitudinal investigation of thromboembolism etiology - 25/08/11
, Albert W Tsai, PhD b, Richard H White, MD d, Susan R Heckbert, MD, PhD c, Wayne D Rosamond, PhD e, Paul Enright, MD f, Aaron R Folsom, MD, MPH bAbstract |
Purpose |
To determine the incidence of deep vein thrombosis and pulmonary embolism in two cohorts representing regions of the United States.
Methods |
The sample comprised 21,680 participants of the Atherosclerosis Risk in Communities study and the Cardiovascular Health Study. Subjects were aged ≥45 years, resided in six communities, and were followed for 7.6 years. All hospitalizations were identified and thromboses were validated by chart review.
Results |
The age-standardized incidence of first-time venous thromboembolism was 1.92 per 1000 person-years. Rates were higher in men than women, and increased with age in both sexes. There was no antecedent trauma, surgery, immobilization, or diagnosis of cancer for 48% (175/366) of events. The 28-day case-fatality rate was 11% (29/265) after a first venous thromboembolism and 25% (17/67) for cancer-associated thrombosis. The recurrence rate 2 years after a first venous thromboembolism was 7.7% per year (95% confidence interval [CI]: 4.5% to 10.9% per year). Cancer was the only factor independently associated with 28-day fatality (relative risk [RR] = 5.2; 95% CI: 1.4 to 19.9) or recurrent thrombosis (RR = 9.2; 95% CI: 2.0 to 41.7).
Conclusion |
The incidence of venous thromboembolism in this cohort of middle- and older-aged subjects was similar to that observed in more geographically homogenous samples. Half of cases were idiopathic. Short-term mortality and 2-year recurrence rates were appreciable, especially among subjects with cancer. Based on this study we estimate that 187,000 cases of first-time venous thromboembolism are diagnosed yearly in the United States among those aged 45 years or older.
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 | The Atherosclerosis Risk in Communities Study was funded by contracts HC-55015, HC-55016, HC-55018, HC-55019, HC-55020, HC-55021, and HC-55022; the Cardiovascular Health Study was funded by contracts HC-85079 to HC-85086; and the Longitudinal Investigation of Thromboembolism Etiology study was funded by grant HL59367; all from the National Heart, Lung, and Blood Institute, Bethesda, Maryland. |
Vol 117 - N° 1
P. 19-25 - juillet 2004 Retour au numéro
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