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Cardiovascular risk factors and venous thromboembolism: a meta-analysis.
Circulation 2008; 117(1):93-102Circ

Abstract

BACKGROUND

The concept that venous thromboembolism (VTE) and atherosclerosis are 2 completely distinct entities has recently been challenged because patients with VTE have more asymptomatic atherosclerosis and more cardiovascular events than control subjects. We performed a meta-analysis to assess the association between cardiovascular risk factors and VTE.

METHODS AND RESULTS

Medline and EMBASE databases were searched to identify studies that evaluated the prevalence of major cardiovascular risk factors in VTE patients and control subjects. Studies were selected using a priori defined criteria, and each study was reviewed by 2 authors who abstracted data on study characteristics, study quality, and outcomes. Odds ratios or weighted means and 95% confidence intervals (CIs) were then calculated and pooled using a random-effects model. Statistical heterogeneity was evaluated through the use of chi2 and I2 statistics. Twenty-one case-control and cohort studies with a total of 63 552 patients met the inclusion criteria. Compared with control subjects, the risk of VTE was 2.33 for obesity (95% CI, 1.68 to 3.24), 1.51 for hypertension (95% CI, 1.23 to 1.85), 1.42 for diabetes mellitus (95% CI, 1.12 to 1.77), 1.18 for smoking (95% CI, 0.95 to 1.46), and 1.16 for hypercholesterolemia (95% CI, 0.67 to 2.02). Weighted mean high-density lipoprotein cholesterol levels were significantly lower in VTE patients, whereas no difference was observed for total and low-density lipoprotein cholesterol levels. Significant heterogeneity among studies was present in all subgroups except for the diabetes mellitus subgroup. Higher-quality studies were more homogeneous, and significant associations remained unchanged.

CONCLUSIONS

Cardiovascular risk factors are associated with VTE. This association is clinically relevant with respect to individual screening, risk factor modification, and primary and secondary prevention of VTE. Prospective studies should further investigate the underlying mechanisms of this relationship.

Authors+Show Affiliations

Department of Clinical Medicine, University of Insubria, Varese, Italy. agewal@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Meta-Analysis

Language

eng

PubMed ID

18086925

Citation

Ageno, Walter, et al. "Cardiovascular Risk Factors and Venous Thromboembolism: a Meta-analysis." Circulation, vol. 117, no. 1, 2008, pp. 93-102.
Ageno W, Becattini C, Brighton T, et al. Cardiovascular risk factors and venous thromboembolism: a meta-analysis. Circulation. 2008;117(1):93-102.
Ageno, W., Becattini, C., Brighton, T., Selby, R., & Kamphuisen, P. W. (2008). Cardiovascular risk factors and venous thromboembolism: a meta-analysis. Circulation, 117(1), pp. 93-102.
Ageno W, et al. Cardiovascular Risk Factors and Venous Thromboembolism: a Meta-analysis. Circulation. 2008 Jan 1;117(1):93-102. PubMed PMID: 18086925.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cardiovascular risk factors and venous thromboembolism: a meta-analysis. AU - Ageno,Walter, AU - Becattini,Cecilia, AU - Brighton,Timothy, AU - Selby,Rita, AU - Kamphuisen,Pieter W, Y1 - 2007/12/17/ PY - 2007/12/19/pubmed PY - 2008/1/26/medline PY - 2007/12/19/entrez SP - 93 EP - 102 JF - Circulation JO - Circulation VL - 117 IS - 1 N2 - BACKGROUND: The concept that venous thromboembolism (VTE) and atherosclerosis are 2 completely distinct entities has recently been challenged because patients with VTE have more asymptomatic atherosclerosis and more cardiovascular events than control subjects. We performed a meta-analysis to assess the association between cardiovascular risk factors and VTE. METHODS AND RESULTS: Medline and EMBASE databases were searched to identify studies that evaluated the prevalence of major cardiovascular risk factors in VTE patients and control subjects. Studies were selected using a priori defined criteria, and each study was reviewed by 2 authors who abstracted data on study characteristics, study quality, and outcomes. Odds ratios or weighted means and 95% confidence intervals (CIs) were then calculated and pooled using a random-effects model. Statistical heterogeneity was evaluated through the use of chi2 and I2 statistics. Twenty-one case-control and cohort studies with a total of 63 552 patients met the inclusion criteria. Compared with control subjects, the risk of VTE was 2.33 for obesity (95% CI, 1.68 to 3.24), 1.51 for hypertension (95% CI, 1.23 to 1.85), 1.42 for diabetes mellitus (95% CI, 1.12 to 1.77), 1.18 for smoking (95% CI, 0.95 to 1.46), and 1.16 for hypercholesterolemia (95% CI, 0.67 to 2.02). Weighted mean high-density lipoprotein cholesterol levels were significantly lower in VTE patients, whereas no difference was observed for total and low-density lipoprotein cholesterol levels. Significant heterogeneity among studies was present in all subgroups except for the diabetes mellitus subgroup. Higher-quality studies were more homogeneous, and significant associations remained unchanged. CONCLUSIONS: Cardiovascular risk factors are associated with VTE. This association is clinically relevant with respect to individual screening, risk factor modification, and primary and secondary prevention of VTE. Prospective studies should further investigate the underlying mechanisms of this relationship. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/18086925/Cardiovascular_risk_factors_and_venous_thromboembolism:_a_meta_analysis_ L2 - http://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.107.709204?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -