Leiden University Medical Center, Department of Clinical Epidemiology, Leiden, the Netherlands.
Department of Medicine, Larner College of Medicine at the University of Vermont, Burlington.
JAMA Netw Open. 2022 Mar 1;5(3):e224205. doi: 10.1001/jamanetworkopen.2022.4205.
Previous venous thrombosis (VT) is associated with risk of future VT, but quantification of risk over the life course is poorly understood. More information is needed for clinicians to understand the association of remote history of VT with the risk of VT in older patients.
To assess the association between a remote history of VT and the development of VT in older age.
DESIGN, SETTING, AND PARTICIPANTS: The Age and Thrombosis, Acquired and Genetic Risk Factors in the Elderly case-control study enrolled patients 70 years and older with VT and control individuals 70 years and older without VT between June 2008 and August 2011. The Age and Thrombosis, Acquired and Genetic Risk Factors in the Elderly study is a 2-center, population-based case-control study that was conducted in Burlington, Vermont, in the US and in Leiden, the Netherlands. Consecutively diagnosed patients with an objectively proven episode of VT (deep vein thrombosis of the leg or pulmonary embolism) were included. Control individuals were identified in the same geographic areas as the patients and were randomly selected. Data were analyzed between May 2021 and October 2021.
Self-reported remote VT (occurring >10 years before to enrollment).
The main outcome was the risk of VT at older age. The association of self-reported history of remote VT with VT at older age was assessed by calculating odds ratios (ORs) as estimates of relative risk with 95% CIs.
A total of 460 patients with VT and 456 control participants were included. There were slightly more women than men in both groups (60.2% of patients [n = 277] were women and 52.4% of control participants [n = 239] were women), and the mean (range) age of patients was 78.7 (70.0-100.9) years, which was similar to the control participants. Compared with individuals without remote VT, those with a remote history of VT had an increased risk of VT (OR, 2.54; 95% CI, 1.56-4.13). The crude risk estimate was robust to adjustment and time since remote VT, that is, individuals with a VT 10 to 30 years ago (OR, 2.74; 95% CI, 1.34-5.57) and those with a VT more than 30 years ago (OR, 2.42; 95% CI, 1.21-4.84) had a an increased risk of VT. The population-attributable fraction of a remote history of VT was 7.7%.
In this study, a remote history of VT was associated with risk of VT in older individuals. This quantification could assist clinicians in advising patients on VT prevention.
先前的静脉血栓形成（VT）与未来 VT 的风险相关，但对整个生命过程中的风险程度了解甚少。临床医生需要更多信息来了解 VT 病史与老年患者 VT 风险之间的关联。
评估远程 VT 病史与老年患者 VT 发展之间的关联。
设计、地点和参与者：年龄和血栓形成、老年患者获得性和遗传风险因素病例对照研究纳入了 2008 年 6 月至 2011 年 8 月期间 70 岁及以上患有 VT 的患者和 70 岁及以上无 VT 的对照个体。年龄和血栓形成、老年患者获得性和遗传风险因素研究是一项在美国佛蒙特州伯灵顿和荷兰莱顿进行的 2 中心、基于人群的病例对照研究。纳入了经客观证实的腿部深静脉血栓形成或肺栓塞发作的 VT 患者。在与患者相同的地理区域随机选择对照个体。数据分析于 2021 年 5 月至 2021 年 10 月之间进行。
自我报告的远程 VT（发生在入组前 10 年以上）。
主要结局是老年时 VT 的风险。通过计算比值比（OR）作为相对风险的估计值（95%CI），评估自我报告的远程 VT 史与老年时 VT 之间的关联。
共纳入 460 名 VT 患者和 456 名对照参与者。两组中女性多于男性（60.2%的患者[n=277]为女性，52.4%的对照参与者[n=239]为女性），患者的平均（范围）年龄为 78.7（70.0-100.9）岁，与对照参与者相似。与无远程 VT 者相比，有远程 VT 病史者 VT 风险增加（OR，2.54；95%CI，1.56-4.13）。粗风险估计值在调整和远程 VT 后仍然稳健，即 10-30 年前发生 VT（OR，2.74；95%CI，1.34-5.57）和 30 年前发生 VT（OR，2.42；95%CI，1.21-4.84）的患者 VT 风险增加。远程 VT 病史的人群归因分数为 7.7%。
在这项研究中，远程 VT 病史与老年个体 VT 风险相关。这种量化可以帮助临床医生为 VT 预防向患者提供建议。
