Lifetime Risk of Venous Thromboembolism in Two Cohort Studies

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 thro...

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Vydané v:The American journal of medicine Ročník 129; číslo 3; s. 339.e19
Hlavní autori: Bell, Elizabeth J, Lutsey, Pamela L, Basu, Saonli, Cushman, Mary, Heckbert, Susan R, Lloyd-Jones, Donald M, Folsom, Aaron R
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: United States 01.03.2016
Predmet:
Aged
Anemia, Sickle Cell - epidemiology
Black or African American
Black People - statistics & numerical data
Cohort Studies
Factor V - genetics
Follow-Up Studies
Heterozygote
Humans
Kaplan-Meier Estimate
Middle Aged
Obesity - epidemiology
Risk
Sickle Cell Trait - epidemiology
United States - epidemiology
Venous Thromboembolism - epidemiology
United States
Epidemiology
Thrombosis
Embolism
Risk factors
ISSN:1555-7162, 1555-7162
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Abstract 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. 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. 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. 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.
AbstractList 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. 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. 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. 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.
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.BACKGROUNDGreater 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.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.METHODSWe 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.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.RESULTSAt 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.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.CONCLUSIONSAt 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.
Author Bell, Elizabeth J
Lutsey, Pamela L
Lloyd-Jones, Donald M
Heckbert, Susan R
Folsom, Aaron R
Basu, Saonli
Cushman, Mary
Author_xml – sequence: 1
  givenname: Elizabeth J
  surname: Bell
  fullname: Bell, Elizabeth J
  email: ebell@umn.edu
  organization: Division of Epidemiology & Community Health, University of Minnesota, Minneapolis. Electronic address: ebell@umn.edu
– sequence: 2
  givenname: Pamela L
  surname: Lutsey
  fullname: Lutsey, Pamela L
  organization: Division of Epidemiology & Community Health, University of Minnesota, Minneapolis
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  givenname: Saonli
  surname: Basu
  fullname: Basu, Saonli
  organization: Division of Biostatistics, University of Minnesota, Minneapolis
– sequence: 4
  givenname: Mary
  surname: Cushman
  fullname: Cushman, Mary
  organization: Division of Hematology/Oncology, Department of Medicine, University of Vermont, Burlington
– sequence: 5
  givenname: Susan R
  surname: Heckbert
  fullname: Heckbert, Susan R
  organization: Cardiovascular Health Research Unit and Department of Epidemiology, University of Washington, Seattle
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  surname: Lloyd-Jones
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  organization: Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
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  givenname: Aaron R
  surname: Folsom
  fullname: Folsom, Aaron R
  organization: Division of Epidemiology & Community Health, University of Minnesota, Minneapolis
BackLink https://www.ncbi.nlm.nih.gov/pubmed/26597668$$D View this record in MEDLINE/PubMed
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Snippet Greater public awareness of venous thromboembolism may be an important next step for optimizing venous thromboembolism prevention and treatment. "Lifetime...
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SubjectTerms Aged
Anemia, Sickle Cell - epidemiology
Black or African American
Black People - statistics & numerical data
Cohort Studies
Factor V - genetics
Follow-Up Studies
Heterozygote
Humans
Kaplan-Meier Estimate
Middle Aged
Obesity - epidemiology
Risk
Sickle Cell Trait - epidemiology
United States - epidemiology
Venous Thromboembolism - epidemiology
Title Lifetime Risk of Venous Thromboembolism in Two Cohort Studies
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