Nilausen Kristin Felicia, Landt Eskild Morten, Al-Shuweli Suzan, Nordestgaard Børge G, Bødtger Uffe, Dahl Morten
Department of Clinical Biochemistry, Zealand University Hospital, Køge, Denmark.
Department of Clinical Biochemistry, Herlev-Gentofte Hospital, Herlev, Denmark.
ERJ Open Res. 2023 Nov 20;9(6). doi: 10.1183/23120541.00631-2023. eCollection 2023 Nov.
The most recent guideline on acute pulmonary embolism (PE) indicates possible long-term sequelae such as dyspnoea and chronic thromboembolic pulmonary hypertension after a PE event. However, effects on lung function or asthma risk have not been evaluated in the general population.
We tested whether individuals with a venous thromboembolism (VTE) encompassing PE and deep vein thrombosis (DVT) have reduced lung function, or greater risks of dyspnoea and asthma using data from 102 792 adults from the Copenhagen General Population Study. Diagnoses of PE, DVT and asthma were collected from the national Danish Patient Registry. Factor V Leiden and prothrombin G20210A gene variants were determined using TaqMan assays.
Prevalences of PE, DVT and VTE were 2.2%, 3.6% and 5.2%, respectively. Individuals with VTE had forced expiratory volume in 1 s of 92% predicted compared with 96% pred in individuals without VTE (p<0.001). Individuals with VTE those without had adjusted OR (95% CI) for light, moderate and severe dyspnoea of 1.4 (1.2-1.6), 1.6 (1.4-1.8) and 1.7 (1.5-1.9), respectively. Individuals with VTE those without had an adjusted OR for asthma of 1.6 (95% CI 1.4-1.8). Factor V Leiden and prothrombin G20210A genotype also associated with increased risk of asthma (p for trend=0.002). Population-attributable fractions of severe dyspnoea and asthma due to VTE were 3.5% and 3.0%, respectively, in the population.
Individuals with VTE have worse lung function and higher risks of severe dyspnoea and asthma, and may account for 3.5% and 3.0% of people with severe dyspnoea and asthma, respectively, in the general population.
最新的急性肺栓塞（PE）指南指出，PE事件后可能会出现诸如呼吸困难和慢性血栓栓塞性肺动脉高压等长期后遗症。然而，尚未在普通人群中评估其对肺功能或哮喘风险的影响。
我们利用哥本哈根普通人群研究中102792名成年人的数据，测试了患有包括PE和深静脉血栓形成（DVT）在内的静脉血栓栓塞（VTE）的个体是否肺功能下降，或患呼吸困难和哮喘的风险更高。PE、DVT和哮喘的诊断信息从丹麦国家患者登记处收集。采用TaqMan分析法测定凝血因子V莱顿突变和凝血酶原G20210A基因变异。
PE、DVT和VTE的患病率分别为2.2%、3.6%和5.2%。VTE患者的第1秒用力呼气量预计值为92%，而无VTE患者为96%（p<0.001）。VTE患者与无VTE患者相比，轻度、中度和重度呼吸困难的校正比值比（95%CI）分别为1.4（1.2-1.6）、1.6（1.4-1.8）和1.7（1.5-1.9）。VTE患者与无VTE患者相比，哮喘的校正比值比为1.6（95%CI 1.4-1.8）。凝血因子V莱顿突变和凝血酶原G20210A基因型也与哮喘风险增加相关（趋势p=0.002）。在该人群中，VTE导致的重度呼吸困难和哮喘的人群归因分数分别为3.5%和3.0%。
VTE患者肺功能较差，患重度呼吸困难和哮喘的风险较高，在普通人群中分别可能占重度呼吸困难和哮喘患者的3.5%和3.0%。
