Risk of venous thrombosis in patients with major illnesses: Results from the MEGA study.
J Thromb Haemost. 2012 Oct 26;
Authors: Ocak G, Vossen CY, Verduijn M, Dekker FW, Rosendaal FR, Cannegieter SC, Lijfering WM
Background: The risk of venous thrombosis associated with major illnesses is not well known, as is the combined effect of immobilization, and thrombophilia. The aim of this study was to assess the effect on the development of venous thrombosis of several major illnesses in combination with immobilization, BMI, and thrombophilia to identify high-risk groups that may provide a basis for personalized prevention. Methods: This study included 4311 consecutive patients with a first episode of venous thrombosis and 5768 controls from a case-control study (MEGA study). We calculated odds ratios (ORs) for venous thrombosis for patients with a self-reported history of major illnesses. Results: Venous thrombosis risk was increased for all investigated major illnesses: liver disease (OR) 1.7 (95%CI 1.0-2.9), kidney disease 3.7 (95%CI 2.3-5.9), rheumatoid arthritis 1.5 (95%CI 1.2-1.9), multiple sclerosis 2.4 (95%CI 1.3-4.3), heart failure 1.7 (95%CI 1.2-2.3), hemorrhagic stroke 4.9 (95%CI 2.4-9.9), arterial thrombosis 1.5 (95%CI 1.2-1.8), and in the presence of any of the above major illnesses 1.7 (95%CI 1.5-1.9). Combinations of major illnesses with immobilization and increased factor VIII (odds ratio 79.9; 95%CI 33.2-192.2), increased factor IX (35.3; 95%CI 14.2-87.8), increased von Willebrand factor (88.0; 95%CI 33.9-228.3), factor V Leiden (84.2; 95%CI 19.5-363.6), and blood group non-O (53.1; 95%CI 30.9-91.4) were associated with increased venous thrombosis risks. Conclusions: All major illnesses reported here were associated with an increased risk of venous thrombosis. These risks were most pronounced at time of immobilization or in the presence of thrombophilia. © 2012 International Society on Thrombosis and Haemostasis.
PMID: 23106832 [PubMed - as supplied by publisher]