Determinants of Venous Thromboembolism in Older People

Summary

Principal Investigator: Robert Glynn
Abstract: DESCRIPTION (provided by applicant): Venous thromboembolism (VTE), including both pulmonary embolism and deep vein thrombosis, is an age related condition with potentially catastrophic clinical consequences. Although VTE occurs as frequently as stroke in some populations, its epidemiology is not well understood. The broad goal of this application is to clarify the determinants of VTE, with a particular focus on those influenced by age, both to identify modifiable risk factors as well as those people who would benefit most from preventive strategies. Studies will utilize data from five populations: 39,876 women who participated in the Women's Health Study for over 10 years;29,071 men who participated in the Physicians'Health Studies I and II, of whom 22,071 have over 20 years of follow-up since the initiation of the first trial;8,171 women at high risk of cardiovascular disease who participated in the Women's Antioxidant Cardiovascular Disease Study for an average of 8 years, 508 people with prevalent, idiopathic VTE who participated in the PREVENT trial;and 17,802 people from 26 countries currently participating in the JUPITER trial of statins and cardiovascular disease. Parallel, centralized methods were used to review records and confirm reported cases of VTE. Archived blood samples are available for over 75% of participants. Main relationships to be evaluated include: whether intake of whole grains, fruit, and vegetables influence risk of VTE;the influence of comorbid conditions, especially cancer, cardiovascular disease, stroke and diabetes, on risk of VTE;interactions of genetic determinants of VTE, including factor V Leiden, the prothrombin mutation and polymorphisms in the MTHFR gene with age;whether genetic variants in adhesion molecules influence risk of VTE;and the impact of statins and the metabolic syndrome on risk of VTE. The combined populations will include over 1,500 incident cases of VTE. Studies will consider both a first occurrence of VTE as well as the risk of recurrent VTE. Methods of analysis include Kaplan-Meier estimates of cumulative risk and estimates of the relative hazard of VTE based on proportional hazards models. Strengths of the studies include their prospective design, high follow-up rates, detailed and reliable, long-term exposure and outcome information, and availability of blood samples on a high percentage of the population. Results will help identify high-risk older people, and potentially modifiable behaviors that influence risk of
Funding Period: ----------------2007 - ---------------2011-
more information: NIH RePORT

Top Publications

  1. pmc Lipid biomarkers, hormone therapy and the risk of venous thromboembolism in women
    B M Everett
    The Center for Cardiovascular Disease Prevention, Harvard Medical School, and the Division of Preventive Medicine, Department of Medicine, Brigham and Women s Hospital, Boston, MA 02215, USA
    J Thromb Haemost 7:588-96. 2009
  2. pmc Genetic risk factors in recurrent venous thromboembolism: A multilocus, population-based, prospective approach
    Robert Y L Zee
    Center for Cardiovascular Disease Prevention, Brigham and Women s Hospital, Harvard Medical School, Boston, MA 02215, USA
    Clin Chim Acta 402:189-92. 2009
  3. pmc A randomized trial of rosuvastatin in the prevention of venous thromboembolism
    Robert J Glynn
    Division of Preventive Medicine, Brigham and Women s Hospital, Harvard Medical School, Boston, MA 02215, USA
    N Engl J Med 360:1851-61. 2009
  4. pmc An evaluation of candidate genes of inflammation and thrombosis in relation to the risk of venous thromboembolism: The Women's Genome Health Study
    Robert Y L Zee
    Brigham and Women s Hospital, Harvard Medical School, Boston, MA 02215, USA
    Circ Cardiovasc Genet 2:57-62. 2009
  5. pmc Comparison of associations of adherence to a Dietary Approaches to Stop Hypertension (DASH)-style diet with risks of cardiovascular disease and venous thromboembolism
    K C Fitzgerald
    Division of Preventive Medicine, Department of Medicine, Brigham and Women s Hospital and Harvard Medical School, Boston, MA, USA
    J Thromb Haemost 10:189-98. 2012

Scientific Experts

Detail Information

Publications7

  1. pmc Lipid biomarkers, hormone therapy and the risk of venous thromboembolism in women
    B M Everett
    The Center for Cardiovascular Disease Prevention, Harvard Medical School, and the Division of Preventive Medicine, Department of Medicine, Brigham and Women s Hospital, Boston, MA 02215, USA
    J Thromb Haemost 7:588-96. 2009
    ..Published reports of a relationship between lipids and incident venous thromboembolism (VTE) are conflicting...
  2. pmc Genetic risk factors in recurrent venous thromboembolism: A multilocus, population-based, prospective approach
    Robert Y L Zee
    Center for Cardiovascular Disease Prevention, Brigham and Women s Hospital, Harvard Medical School, Boston, MA 02215, USA
    Clin Chim Acta 402:189-92. 2009
    ....
  3. pmc A randomized trial of rosuvastatin in the prevention of venous thromboembolism
    Robert J Glynn
    Division of Preventive Medicine, Brigham and Women s Hospital, Harvard Medical School, Boston, MA 02215, USA
    N Engl J Med 360:1851-61. 2009
    ..Observational studies have yielded variable estimates of the effect of statin therapy on the risk of venous thromboembolism, and evidence from randomized trials is lacking...
  4. pmc An evaluation of candidate genes of inflammation and thrombosis in relation to the risk of venous thromboembolism: The Women's Genome Health Study
    Robert Y L Zee
    Brigham and Women s Hospital, Harvard Medical School, Boston, MA 02215, USA
    Circ Cardiovasc Genet 2:57-62. 2009
    ..Although pathways associated with hemostasis and thrombosis are well documented to have an impact on venous thromboembolism (VTE), whether the inflammatory cascade also influences VTE risk is uncertain...
  5. pmc Comparison of associations of adherence to a Dietary Approaches to Stop Hypertension (DASH)-style diet with risks of cardiovascular disease and venous thromboembolism
    K C Fitzgerald
    Division of Preventive Medicine, Department of Medicine, Brigham and Women s Hospital and Harvard Medical School, Boston, MA, USA
    J Thromb Haemost 10:189-98. 2012
    ..Venous thromboembolism (VTE) and cardiovascular disease (CVD) share some risk factors, including obesity, but it is unclear how dietary patterns associated with reduced risk of CVD relate to risk of VTE...