Peripheral artery disease and the risk of venous thromboembolism
| العنوان: | Peripheral artery disease and the risk of venous thromboembolism |
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| المؤلفون: | Daniel Sykora, Christine Firth, Marlene Girardo, Shubhang Bhatt, Andrew Tseng, Alanna Chamberlain, David Liedl, Paul Wennberg, Fadi Elias Shamoun |
| المصدر: | Vasa. 51:365-371 |
| بيانات النشر: | Hogrefe Publishing Group, 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Aged, 80 and over, Venous Thrombosis, Peripheral Arterial Disease, Risk Factors, Humans, Anticoagulants, Venous Thromboembolism, Middle Aged, Pulmonary Embolism, Cardiology and Cardiovascular Medicine, Aged |
| الوصف: | Summary: Background: Peripheral artery disease (PAD) impacts 3–12% of patients worldwide and is characterized by endothelial dysfunction and inflammatory pathways which are also common to venous thromboembolism (VTE), but there is a paucity of evidence regarding VTE risk in PAD patients. We investigated whether PAD is an independent risk factor for VTE. Patients and methods: We reviewed medical records of patients undergoing ABI studies at Mayo Clinic from 01/1996-02/2020. We classified patients by ABI (low [1.4]), as well as by specific low ABI subgroup: severely reduced (ABI: 0.00–0.39), moderately reduced (0.40–0.69), mildly reduced (0.70–0.90), and borderline reduced (0.91–0.99). The primary outcome was incident VTE event (acute lower extremity deep vein thrombosis or pulmonary embolism) after ABI measurement. Multivariable Cox proportional regression was used to calculate hazard ratios (HR) with 95% confidence intervals (CI) after adjusting for age, sex, active smoking, cancer, previous VTE, thrombophilia, anticoagulation, and revascularization. Results: 39,834 unique patients (mean age 66.3±14.3 years, median follow-up 34 months) were identified. 2,305 VTE events occurred in patients without PAD (13.0%), 2,218 in low ABI patients (13.0%), and 751 in elevated ABI patients (14.8%). After risk factor adjustment, VTE risk was modestly increased for PAD overall (HR: 1.12, 95% CI [1.06, 1.18]), including low ABI (HR: 1.11, 95% CI [1.04, 1.18]) and elevated ABI groups (HR: 1.15, 95% CI [1.04, 1.26]), compared to patients without PAD. The greatest VTE risk was in severely low ABI patients (HR: 1.46, 95% CI [1.31, 1.64]). Conclusions: In a large longitudinal cohort, we present strong clinical evidence of PAD, with low and elevated ABI, as an independent VTE risk factor, with the highest risk seen in patients with severely low ABI. Continued research is required to further investigate this relationship and its intersection with functional performance status to optimize VTE risk reduction or anticoagulation strategies in the PAD population. |
| تدمد: | 1664-2872 0301-1526 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::91ef54bf7b1da55677a04d5a3d82a897 https://doi.org/10.1024/0301-1526/a001029 |
| رقم الأكسشن: | edsair.doi.dedup.....91ef54bf7b1da55677a04d5a3d82a897 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 16642872 03011526 |
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