Lind Caroline, Småbrekke Birgit, Rinde Ludvig Balteskard, Hindberg Kristian, Mathiesen Ellisiv Bøgeberg, Johnsen Stein Harald, Arntzen Kjell Arne, Njølstad Inger, Lijfering Willem, Brækkan Sigrid Kufaas, Hansen John-Bjarne
K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway.
Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway.
TH Open. 2017 Jun 28;1(1):e66-e72. doi: 10.1055/s-0037-1603983. eCollection 2017 Jun.
Venous thromboembolism (VTE) is associated with increased risk of arterial cardiovascular diseases (CVD), and development of atherosclerosis secondary to VTE may be an intermediate between VTE and CVD. Therefore, we aimed to investigate whether incident VTE was associated with subsequent carotid atherosclerosis formation and progression in a population-based observational study. Subjects attending two or more ultrasound examinations of the right carotid artery, with measurement of total plaque area (TPA), in the Tromsø Study in 1994-1995, 2001-2002, and/or 2007-2008 were eligible. We identified 150 subjects diagnosed with first-lifetime VTE between the initial and follow-up visit, and randomly selected 600 age- and sex-matched subjects without VTE between the visits. Subjects with VTE and carotid plaque(s) at the first visit had 4.1 mm (β: 4.13, 95% CI: -1.72 to 9.98) larger change in TPA between the first and second visit compared with subjects without VTE after adjustment for change in high-sensitivity C-reactive protein (hs-CRP) and traditional atherosclerotic risk factors. The association remained after restricting the analyses to VTE events diagnosed in the first half of the time interval between the carotid ultrasounds (β: 4.02, 95% CI: -3.66 to 11.70), supporting that the change in TPA occurred subsequent to the VTE. No association was found between VTE and novel carotid plaque formation. In conclusion, we found a possible association between VTE and atherosclerosis progression in those with already established carotid plaques, but not between VTE and novel plaque formation. The association between VTE and carotid plaque progression was not mediated by low-grade inflammation assessed by hs-CRP.
静脉血栓栓塞症（VTE）与动脉心血管疾病（CVD）风险增加相关，VTE继发的动脉粥样硬化发展可能是VTE与CVD之间的一个中间环节。因此，在一项基于人群的观察性研究中，我们旨在调查新发VTE是否与随后的颈动脉粥样硬化形成及进展相关。在1994 - 1995年、2001 - 2002年和/或2007 - 2008年的特罗姆瑟研究中，接受过两次或更多次右侧颈动脉超声检查且测量了总斑块面积（TPA）的受试者符合条件。我们确定了150名在初次就诊和随访之间被诊断为首次发生VTE的受试者，并随机选择了600名在两次就诊之间年龄和性别匹配但无VTE的受试者。在调整了高敏C反应蛋白（hs-CRP）变化和传统动脉粥样硬化危险因素后，与无VTE的受试者相比，首次就诊时患有VTE和颈动脉斑块的受试者在第一次和第二次就诊之间TPA的变化大4.1毫米（β：4.13，95%CI：-1.72至9.98）。在将分析限制于颈动脉超声检查时间间隔前半段诊断的VTE事件后，该关联仍然存在（β：4.02，95%CI：-3.66至11.70），支持TPA的变化发生在VTE之后。未发现VTE与新的颈动脉斑块形成之间存在关联。总之，我们发现VTE与已有颈动脉斑块者的动脉粥样硬化进展之间可能存在关联，但VTE与新斑块形成之间无关联。VTE与颈动脉斑块进展之间的关联并非由hs-CRP评估的低度炎症介导。
