Title | Lifetime Risk of Venous Thromboembolism in Two Cohort Studies. |
Publication Type | Journal Article |
Year of Publication | 2016 |
Authors | Bell, EJ, Lutsey, PL, Basu, S, Cushman, M, Heckbert, SR, Lloyd-Jones, DM, Folsom, AR |
Journal | Am J Med |
Volume | 129 |
Issue | 3 |
Pagination | 339.e19-26 |
Date Published | 2016 Mar |
ISSN | 1555-7162 |
Keywords | African Continental Ancestry Group, Aged, Anemia, Sickle Cell, Cohort Studies, Factor V, Follow-Up Studies, Heterozygote, Humans, Kaplan-Meier Estimate, Middle Aged, Obesity, Risk, Sickle Cell Trait, United States, Venous Thromboembolism |
Abstract | <p><b>BACKGROUND: </b>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.</p><p><b>METHODS: </b>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.</p><p><b>RESULTS: </b>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.</p><p><b>CONCLUSIONS: </b>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.</p> |
DOI | 10.1016/j.amjmed.2015.10.014 |
Alternate Journal | Am. J. Med. |
PubMed ID | 26597668 |
PubMed Central ID | PMC4771407 |
Grant List | HHSN268200800007C / HL / NHLBI NIH HHS / United States HHSN268200800007C / / PHS HHS / United States HHSN268201100005C / HL / NHLBI NIH HHS / United States HHSN268201100005C / / PHS HHS / United States HHSN268201100006C / HL / NHLBI NIH HHS / United States HHSN268201100006C / / PHS HHS / United States HHSN268201100007C / HL / NHLBI NIH HHS / United States HHSN268201100007C / / PHS HHS / United States HHSN268201100008C / HL / NHLBI NIH HHS / United States HHSN268201100008C / / PHS HHS / United States HHSN268201100009C / HL / NHLBI NIH HHS / United States HHSN268201100009C / / PHS HHS / United States HHSN268201100010C / HL / NHLBI NIH HHS / United States HHSN268201100010C / / PHS HHS / United States HHSN268201100011C / HL / NHLBI NIH HHS / United States HHSN268201100011C / / PHS HHS / United States HHSN268201100012C / HL / NHLBI NIH HHS / United States HHSN268201100012C / / PHS HHS / United States HHSN268201200036C / HL / NHLBI NIH HHS / United States HHSN268201200036C / / PHS HHS / United States N01HC55222 / HC / NHLBI NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States N01HC85079 / HC / NHLBI NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States N01HC85080 / HC / NHLBI NIH HHS / United States N01HC85080 / HL / NHLBI NIH HHS / United States N01HC85081 / HC / NHLBI NIH HHS / United States N01HC85081 / HL / NHLBI NIH HHS / United States N01HC85082 / HC / NHLBI NIH HHS / United States N01HC85082 / HL / NHLBI NIH HHS / United States N01HC85083 / HC / NHLBI NIH HHS / United States N01HC85083 / HL / NHLBI NIH HHS / United States N01HC85086 / HC / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States R01 AG023629 / AG / NIA NIH HHS / United States R01 HL059367 / HL / NHLBI NIH HHS / United States R01AG023629 / AG / NIA NIH HHS / United States T32 HL007779 / HL / NHLBI NIH HHS / United States T32HL007779 / HL / NHLBI NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States U01HL080295 / HL / NHLBI NIH HHS / United States |