Wang Huijie, Rosendaal Frits R, Cushman Mary, van Hylckama Vlieg Astrid
Department of Clinical Epidemiology Leiden University Medical Center Leiden The Netherlands.
Department of Medicine Larner College of Medicine at the University of Vermont Burlington Vermont USA.
Res Pract Thromb Haemost. 2021 Jun 21;5(5):e12536. doi: 10.1002/rth2.12536. eCollection 2021 Jul.
A high D-dimer level and parameters of the thrombin generation (TG) potential are associated with the risk of a first venous thrombosis (VT) in young and middle-aged populations.
To investigate whether D-dimer and TG potential (lag-time, time-to-peak [ttPeak], peak thrombin, endogenous thrombin potential [ETP], and velocity index), are associated with the risk of a first VT in those aged 70 years and older.
We included 215 patients with a first VT and 358 controls, all aged >70 years, from the Age and Thrombosis, Acquired and Genetic Risk Factors in the Elderly (AT-AGE) study. To assess the risk of VT, odds ratios with 95% confidence intervals (CIs) were estimated using logistic regression analysis.
D-dimer and all TG parameters except lag time were associated with an increased risk of VT in a dose-response manner. Comparing the fourth with the first quartile (for ttPeak comparing the first with the fourth quartile), risk estimates were: 7.8 (95% CI, 4.0-15.0) for peak, 2.0 (95% CI, 1.2-3.3) for ttPeak, 9.1 (95% CI, 4.4-18.9) for ETP, and 11.5 (95% CI, 5.7-23.3) for velocity index. Comparing the highest quartile of D-dimer with the lowest, the risk was 7.7-fold increased (95% CI, 4.0-14.8). Furthermore, all factors also increased the risk of VT after dichotomizing at more extreme cutoff values. The risk of VT was further increased in the presence of multiple prothrombotic TG parameters and elevated D-dimer level or in combination with prothrombotic mutations.
D-dimer and TG parameters (except lag time) are associated with the risk of first VT in elderly population.
在年轻和中年人群中，高D-二聚体水平和凝血酶生成（TG）潜能参数与首次静脉血栓形成（VT）风险相关。
调查D-二聚体和TG潜能（滞后时间、达到峰值时间[ttPeak]、凝血酶峰值、内源性凝血酶潜能[ETP]和速度指数）是否与70岁及以上人群首次VT风险相关。
我们纳入了来自老年人群年龄与血栓形成、获得性和遗传风险因素（AT-AGE）研究的215例首次发生VT的患者和358例对照，所有患者年龄均大于70岁。为评估VT风险，采用逻辑回归分析估计95%置信区间（CI）的比值比。
D-二聚体和除滞后时间外的所有TG参数均以剂量反应方式与VT风险增加相关。将第四个四分位数与第一个四分位数进行比较（对于ttPeak，将第一个四分位数与第四个四分位数进行比较），风险估计值如下：凝血酶峰值为7.8（95%CI，4.0-15.0），ttPeak为2.0（95%CI，1.2-3.3），ETP为9.1（95%CI，4.4-18.9），速度指数为11.5（95%CI，5.7-23.3）。将D-二聚体的最高四分位数与最低四分位数进行比较，风险增加7.7倍（95%CI，4.0-14.8）。此外，在更极端的临界值进行二分法后，所有因素也增加了VT风险。在存在多个促血栓形成TG参数和D-二聚体水平升高或与促血栓形成突变联合存在时，VT风险进一步增加。
D-二聚体和TG参数（除滞后时间外）与老年人群首次VT风险相关。
