Title | Deep vein thrombosis and pulmonary embolism in two cohorts: the longitudinal investigation of thromboembolism etiology. |
Publication Type | Journal Article |
Year of Publication | 2004 |
Authors | Cushman, M, Tsai, AW, White, RH, Heckbert, SR, Rosamond, WD, Enright, P, Folsom, AR |
Journal | Am J Med |
Volume | 117 |
Issue | 1 |
Pagination | 19-25 |
Date Published | 2004 Jul 01 |
ISSN | 0002-9343 |
Keywords | Aged, Case-Control Studies, Cohort Studies, Female, Follow-Up Studies, Humans, Incidence, Male, Middle Aged, Neoplasms, Population Surveillance, Pulmonary Embolism, Recurrence, Risk Factors, Survival Rate, Venous Thrombosis |
Abstract | <p><b>PURPOSE: </b>To determine the incidence of deep vein thrombosis and pulmonary embolism in two cohorts representing regions of the United States.</p><p><b>METHODS: </b>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.</p><p><b>RESULTS: </b>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).</p><p><b>CONCLUSION: </b>The incidence of venous thromboembolism in this cohort of middle- and older-aged subjects was similar to that observed in more geographically homogeneous 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.</p> |
DOI | 10.1016/j.amjmed.2004.01.018 |
Alternate Journal | Am J Med |
PubMed ID | 15210384 |
Grant List | HC-55015 / HC / NHLBI NIH HHS / United States HC-55016 / HC / NHLBI NIH HHS / United States HC-55018 / HC / NHLBI NIH HHS / United States HC-55019 / HC / NHLBI NIH HHS / United States HC-55020 / HC / NHLBI NIH HHS / United States HC-55021 / HC / NHLBI NIH HHS / United States HC-55022 / HC / NHLBI NIH HHS / United States HC-85079 / HC / NHLBI NIH HHS / United States HC-85086 / HC / NHLBI NIH HHS / United States HL59367 / HL / NHLBI NIH HHS / United States |