Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy.
Department of General Surgery and Surgical Specialty Paride Stefanini, Sapienza University of Rome, 00161 Rome, Italy.
Int J Mol Sci. 2023 Feb 5;24(4):3169. doi: 10.3390/ijms24043169.
Venous thromboembolism (VTE) is the third most common cause of death worldwide. The incidence of VTE varies according to different countries, ranging from 1-2 per 1000 person-years in Western Countries, while it is lower in Eastern Countries (<1 per 1000 person-years). Many risk factors have been identified in patients developing VTE, but the relative contribution of each risk factor to thrombotic risk, as well as pathogenetic mechanisms, have not been fully described. Herewith, we provide a comprehensive review of the most common risk factors for VTE, including male sex, diabetes, obesity, smoking, Factor V Leiden, Prothrombin G20210A Gene Mutation, Plasminogen Activator Inhibitor-1, oral contraceptives and hormonal replacement, long-haul flight, residual venous thrombosis, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, trauma and fractures, pregnancy, immobilization, antiphospholipid syndrome, surgery and cancer. Regarding the latter, the incidence of VTE seems highest in pancreatic, liver and non-small cells lung cancer (>70 per 1000 person-years) and lowest in breast, melanoma and prostate cancer (<20 per 1000 person-years). In this comprehensive review, we summarized the prevalence of different risk factors for VTE and the potential molecular mechanisms/pathogenetic mediators leading to VTE.
静脉血栓栓塞症(VTE)是全球范围内第三大常见的死亡原因。VTE 的发病率因国家而异,西方国家为每 1000 人年 1-2 例,而东方国家则较低(<1/1000 人年)。许多风险因素已在发生 VTE 的患者中得到确认,但每个风险因素对血栓形成风险的相对贡献以及发病机制尚未得到充分描述。在此,我们全面回顾了 VTE 的最常见风险因素,包括男性、糖尿病、肥胖、吸烟、因子 V 莱顿突变、凝血酶原 G20210A 基因突变、纤溶酶原激活物抑制剂-1、口服避孕药和激素替代疗法、长途飞行、残留静脉血栓形成、严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)感染、创伤和骨折、妊娠、固定、抗磷脂综合征、手术和癌症。至于后者,VTE 的发生率似乎在胰腺、肝脏和非小细胞肺癌中最高(>70/1000 人年),在乳腺癌、黑色素瘤和前列腺癌中最低(<20/1000 人年)。在本综述中,我们总结了 VTE 的不同风险因素的流行情况,以及导致 VTE 的潜在分子机制/发病介质。