VTE risk independent of lipid levels
MedWire News: Venous thromboembolism (VTE) and atherosclerosis do not share lipid risk factors, suggest findings from the Copenhagen City Heart Study.
The researchers found that smoking and obesity increased the risk for VTE, but there was no such correlation between VTE risk and levels of lipoprotein cholesterol, trigyclerides, or diabetes.
The studies contradict those previously reported by MedWire News from the Justification for the Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin (JUPITER) study, which indicated that lipid lowering could reduce the risk for VTE.
“This would indicate that any beneficial effect of statins on VTE is through pleiotropic mechanisms and that treatment of dyslipidemia in itself may be of low value for preventing VTE,” comment Anders Holst (University Hospital Rigshospitalet, Copenhagen, Denmark) and co-authors.
“Conversely, management of obesity and smoking cessation are likely to be beneficial for both VTE and atherosclerotic disease,” they say.
The team examined data from the Copenhagen City Heart Study from1976–2007 for 18,954 individuals who were followed-up for a median of 19.5 years or 360,399 person-years. During this time, 969 of the participants experienced a first episode of deep vein thrombosis or pulmonary embolism, giving a rate of 2.69 cases per 1000 person-years.
Multivariate analysis indicates that, after adjusting for age and calendar time, the risk for VTE was significantly greater in those with a body mass index of 35 kg/m2 versus 20 kg/m2 (hazard ratio [HR]=2.10). Smoking 25 g or more of tobacco per day gave a HR of 1.52 versus never smoking, while men were more likely to experience VTE than women (HR=1.24).
The risk for VTE was also increased in those with the highest versus lowest diastolic blood pressure (>100 mmHg vs <80 mmHg, HR=1.34), but reduced by higher household income (medium vs low =0.82).
In contrast, diabetes, hypertension, levels of total, high-density or low-density cholesterol or triglycerides, and physical inactivity did not significantly predict the risk for VTE.
“Reports that cardiovascular disease and VTE share most major risk factors could not be confirmed in this large prospective, population-based study of risk factors for VTE,” Holst et al therefore conclude in the journal Circulation.
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By Lynda Williams