02003nas a2200217 4500008004100000022001400041245008900055210006900144260001300213300000900226490000800235520136200243100002301605700002101628700002201649700002201671700001901693700001801712700001901730856003601749 2016 eng d a1872-822700aDiabetes mellitus and venous thromboembolism: A systematic review and meta-analysis.0 aDiabetes mellitus and venous thromboembolism A systematic review c2016 Jan a10-80 v1113 a

UNLABELLED: Diabetes mellitus (DM) may be a risk factor for venous thromboembolism (VTE) but results are inconsistent.

AIM: We conducted a systematic review and meta-analysis of epidemiologic studies to quantify the association between DM and VTE.

METHODS AND RESULTS: We included studies identified in PubMed, Web of Science, and CINAHL through 07/31/2014. We identified 19 studies that met our selection criteria. We pooled RRs using a random-effects model: the pooled RR for the association of DM with VTE was 1.10 (95% CI: 0.94-1.29). Between-study heterogeneity was explored with a forest plot, funnel plot, meta-regression, and a stratified analysis. Between-study heterogeneity was observed and not explained by study design, method of DM assessment, or degree of adjustment for confounding. Sensitivity analyses omitted one study at a time to assess the influence of any single study on the pooled estimate. These analyses indicated that one large study was highly influential; when this study was excluded, the pooled estimate increased and just reached statistical significance: 1.16 (95% CI: 1.01-1.34).

CONCLUSIONS: This meta-analysis suggests either no association or a modest positive one between DM and VTE in the general population. DM is unlikely to play a major role in VTE development.

1 aBell, Elizabeth, J1 aFolsom, Aaron, R1 aLutsey, Pamela, L1 aSelvin, Elizabeth1 aZakai, Neil, A1 aCushman, Mary1 aAlonso, Alvaro uhttps://chs-nhlbi.org/node/690502847nas a2200397 4500008004100000022001400041245006700055210006600122260001300188300001500201490000800216520175400224653003901978653000902017653002402026653001902050653001302069653002202082653001702104653001102121653002602132653001602158653001202174653000902186653002202195653001802217653002702235100002302262700002202285700001702307700001802324700002302342700002702365700002102392856003602413 2016 eng d a1555-716200aLifetime Risk of Venous Thromboembolism in Two Cohort Studies.0 aLifetime Risk of Venous Thromboembolism in Two Cohort Studies c2016 Mar a339.e19-260 v1293 a

BACKGROUND: Greater public awareness of venous thromboembolism may be an important next step for optimizing venous thromboembolism prevention and treatment. "Lifetime risk" is an easily interpretable way of presenting risk information. Therefore, we sought to calculate the lifetime risk of venous thromboembolism (deep vein thrombosis or pulmonary embolism) using data from 2 large, prospective cohort studies: the Cardiovascular Health Study (CHS) and the Atherosclerosis Risk in Communities (ARIC) study.

METHODS: We followed participants aged 45-64 years in ARIC (n = 14,185) and ≥65 in CHS (n = 5414) at baseline visits (1987-1989 in ARIC, 1989-1990 and 1992-1993 in CHS) for incident venous thromboembolism (n = 728 in ARIC through 2011 and n = 172 in CHS through 2001). We estimated lifetime risks and 95% confidence intervals of incident venous thromboembolism using a modified Kaplan-Meier method, accounting for the competing risk of death from other causes.

RESULTS: At age 45 years, the remaining lifetime risk of venous thromboembolism in ARIC was 8.1% (95% confidence interval, 7.1-8.7). High-risk groups were African Americans (11.5% lifetime risk), those with obesity (10.9%), heterozygous for the factor V Leiden (17.1%), or with sickle cell trait or disease (18.2%). Lifetime risk estimates differed by cohort; these differences were explained by differences in time period of venous thromboembolism ascertainment.

CONCLUSIONS: At least 1 in 12 middle-aged adults will develop venous thromboembolism in their remaining lifetime. This estimate of lifetime risk may be useful to promote awareness of venous thromboembolism and guide decisions at both clinical and policy levels.

10aAfrican Continental Ancestry Group10aAged10aAnemia, Sickle Cell10aCohort Studies10aFactor V10aFollow-Up Studies10aHeterozygote10aHumans10aKaplan-Meier Estimate10aMiddle Aged10aObesity10aRisk10aSickle Cell Trait10aUnited States10aVenous Thromboembolism1 aBell, Elizabeth, J1 aLutsey, Pamela, L1 aBasu, Saonli1 aCushman, Mary1 aHeckbert, Susan, R1 aLloyd-Jones, Donald, M1 aFolsom, Aaron, R uhttps://chs-nhlbi.org/node/690602191nas a2200205 4500008004100000022001400041245008400055210006900139260001300208300001100221490000700232520158100239100002301820700002201843700001801865700002301883700002201906700002101928856003601949 2016 eng d a1941-722500aOrthostatic Hypotension and Risk of Venous Thromboembolism in 2 Cohort Studies.0 aOrthostatic Hypotension and Risk of Venous Thromboembolism in 2  c2016 May a634-400 v293 a

BACKGROUND: Although venous stasis is a risk factor for venous thromboembolism (VTE) and orthostatic hypotension (OH) can cause venous stasis, to our knowledge no study has examined the relationship between OH and VTE risk. We sought to quantify the association between OH and VTE (deep vein thrombosis or pulmonary embolism) using data from 2 large, prospective cohort studies: the Cardiovascular Health Study (CHS) and the Atherosclerosis Risk in Communities (ARIC) Study. We hypothesized that OH was positively associated with incident VTE.

METHODS: We measured OH-defined as a drop in systolic blood pressure (SBP) of at least 20 mm Hg or diastolic blood pressure (DBP) of at least 10 mm Hg within 3 minutes of standing-in participants aged 45-64 years in ARIC (n = 12,480) and ≥65 years in CHS (n = 5,027) at baseline visits (1987-1989 in ARIC; 1989-1990 and 1992-1993 in CHS), and followed participants for incident VTE (n = 568 in ARIC through 2011 and n = 148 in CHS through 2001). We calculated adjusted hazard ratios (HRs) and their 95% confidence intervals (CIs) for incident VTE in relation to OH status.

RESULTS: In CHS, there was a positive association between OH status and incident VTE (HR for VTE = 1.74 (95% CI: 1.20-2.51)). In contrast, there was no association between OH and VTE in the ARIC study (HR for VTE = 0.97 (95% CI: 0.70-1.33)).

CONCLUSIONS: Community-dwelling older adults with OH had a moderately increased risk of VTE. These results were not seen in a population-based middle-aged cohort.

1 aBell, Elizabeth, J1 aAgarwal, Sunil, K1 aCushman, Mary1 aHeckbert, Susan, R1 aLutsey, Pamela, L1 aFolsom, Aaron, R uhttps://chs-nhlbi.org/node/6807