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心肌梗死、血栓前状态基因型与静脉血栓形成风险:特罗姆瑟研究

Myocardial infarction, prothrombotic genotypes, and venous thrombosis risk: The Tromsø Study.

作者信息

Sejrup Joakim K, Morelli Vania M, Løchen Maja-Lisa, Njølstad Inger, Mathiesen Ellisiv B, Wilsgaard Tom, Hansen John-Bjarne, Brækkan Sigrid K

机构信息

K.G. Jebsen-Thrombosis Research and Expertise Center (TREC) Department of Clinical Medicine UiT The Arctic University of Norway Tromsø Norway.

Department of Community Medicine Epidemiology of Chronic Diseases Research Group UiT The Arctic University of Norway Tromsø Norway.

出版信息

Res Pract Thromb Haemost. 2020 Jan 27;4(2):247-254. doi: 10.1002/rth2.12306. eCollection 2020 Feb.

Abstract

BACKGROUND

The risk of venous thromboembolism (VTE) is increased after a myocardial infarction (MI). Some prothrombotic genotypes associated with VTE have also been associated with risk of MI. Whether prothrombotic single-nucleotide polymorphisms (SNPs) further increase the risk of VTE in MI patients is scarcely investigated.

AIM

To study the combined effect of MI and prothrombotic SNPs on the risk of VTE.

METHODS

Cases with incident VTE (n = 641) and a randomly sampled subcohort weighted for age (n = 1761) were identified from the 4 to 6 surveys of the Tromsø Study (1994-2012). DNA was genotyped for rs8176719 (), rs6025 (), rs1799963 (), rs2066865 (), and rs2036914 (). Hazard ratios (HRs) for VTE with 95% confidence intervals (CIs) were estimated by categories of risk alleles and MI status.

RESULTS

Patients with MI had a 1.4-fold increased risk of VTE, and adjustments for the 5 SNPs, either alone or in combination, did not affect this relationship (adjusted HR, 1.52; 95% CI, 1.12-2.07). In subjects without MI, an increased risk of VTE was observed for each of the individual SNPs (≥1 vs. 0 risk alleles), and the risk increased linearly with increasing number of risk alleles in the 5-SNP score. The combination of MI and prothrombotic genotypes, either as individual SNPs or in the 5-SNP score, did not result in an excess risk of VTE.

CONCLUSION

The relationship between MI and VTE was not explained by these 5 prothrombotic genotypes. Prothrombotic genotypes did not yield an excess risk of VTE in patients with MI.

摘要

背景

心肌梗死(MI)后静脉血栓栓塞(VTE)风险增加。一些与VTE相关的促血栓形成基因型也与MI风险相关。促血栓形成单核苷酸多态性(SNP)是否会进一步增加MI患者的VTE风险鲜有研究。

目的

研究MI与促血栓形成SNP对VTE风险的联合作用。

方法

从特罗姆瑟研究(1994 - 2012年)的第4至6次调查中确定新发VTE病例(n = 641)和按年龄加权的随机抽样亚队列(n = 1761)。对rs8176719、rs6025、rs1799963、rs2066865和rs2036914进行DNA基因分型。通过风险等位基因类别和MI状态估计VTE的风险比(HR)及95%置信区间(CI)。

结果

MI患者的VTE风险增加1.4倍,对这5个SNP单独或联合进行校正,均不影响这种关系(校正HR,1.52;95%CI,1.12 - 2.07)。在无MI的受试者中,每个单独的SNP(≥1个风险等位基因与0个风险等位基因相比)均观察到VTE风险增加,且在5 - SNP评分中,风险随风险等位基因数量增加呈线性增加。MI与促血栓形成基因型的组合,无论是作为单个SNP还是5 - SNP评分,均未导致VTE风险增加。

结论

这5种促血栓形成基因型无法解释MI与VTE之间的关系。促血栓形成基因型并未使MI患者的VTE风险增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/baf4/7040547/41dd40f5289d/RTH2-4-247-g001.jpg

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