Hematocrit and incidence of venous thromboembolism.
hematocrit
hemoglobin
prospective studies
pulmonary embolism
venous thrombosis
Journal
Research and practice in thrombosis and haemostasis
ISSN: 2475-0379
Titre abrégé: Res Pract Thromb Haemost
Pays: United States
ID NLM: 101703775
Informations de publication
Date de publication:
Mar 2020
Mar 2020
Historique:
received:
09
12
2019
revised:
14
01
2020
accepted:
24
01
2020
entrez:
27
3
2020
pubmed:
27
3
2020
medline:
27
3
2020
Statut:
epublish
Résumé
Patients with polycythemia vera with high hematocrit have increased risk of venous thromboembolism (VTE). To determine whether high hematocrit in the general population is also associated with elevated VTE risk. The prospective Atherosclerosis Risk in Communities Study performed a complete blood count in 13 891 adults aged 45 to 64 in 1987 to 1989. We identified incident hospitalized VTEs through 2015 and performed proportional hazards regression analyses using race-sex-specific categorization of hematocrit percentiles (ie, <5th, 5th to <25th, 25th to <75th, 75th to <95th, and 95th-100th percentiles, with the 25th to <75th percentile serving as the reference). Over a median follow-up of 26 years, 800 participants had an incident venous thrombosis of the leg and/or a pulmonary embolism. There was a nonlinear association of hematocrit with VTE incidence, with risk elevated 72% for participants above the 95th percentile of hematocrit compared with the reference. Specifically, hazard ratios (95% confidence intervals) of incident VTE were 1.27 (0.91-1.76), 1.06 (0.87-1.28), 1 (reference), 1.17 (0.98-1.40) and 1.72 (1.30-2.27) across the 5 hematocrit percentiles, adjusted for age, race, sex, body mass index, smoking status and pack-years, and other confounding variables. The association of high hematocrit with VTE was limited to provoked VTE, with little evidence for unprovoked VTE. Hemoglobin above the 95th percentile also was associated with an increased risk of VTE. In contrast, there were no significant associations of platelet, leukocyte, neutrophil, or lymphocyte counts with VTE incidence. High hematocrit and hemoglobin in a general middle-aged population sample were associated with increased long-term risk of VTE, particularly provoked VTE.
Sections du résumé
BACKGROUND
BACKGROUND
Patients with polycythemia vera with high hematocrit have increased risk of venous thromboembolism (VTE).
OBJECTIVE
OBJECTIVE
To determine whether high hematocrit in the general population is also associated with elevated VTE risk.
METHODS
METHODS
The prospective Atherosclerosis Risk in Communities Study performed a complete blood count in 13 891 adults aged 45 to 64 in 1987 to 1989. We identified incident hospitalized VTEs through 2015 and performed proportional hazards regression analyses using race-sex-specific categorization of hematocrit percentiles (ie, <5th, 5th to <25th, 25th to <75th, 75th to <95th, and 95th-100th percentiles, with the 25th to <75th percentile serving as the reference).
RESULTS
RESULTS
Over a median follow-up of 26 years, 800 participants had an incident venous thrombosis of the leg and/or a pulmonary embolism. There was a nonlinear association of hematocrit with VTE incidence, with risk elevated 72% for participants above the 95th percentile of hematocrit compared with the reference. Specifically, hazard ratios (95% confidence intervals) of incident VTE were 1.27 (0.91-1.76), 1.06 (0.87-1.28), 1 (reference), 1.17 (0.98-1.40) and 1.72 (1.30-2.27) across the 5 hematocrit percentiles, adjusted for age, race, sex, body mass index, smoking status and pack-years, and other confounding variables. The association of high hematocrit with VTE was limited to provoked VTE, with little evidence for unprovoked VTE. Hemoglobin above the 95th percentile also was associated with an increased risk of VTE. In contrast, there were no significant associations of platelet, leukocyte, neutrophil, or lymphocyte counts with VTE incidence.
CONCLUSION
CONCLUSIONS
High hematocrit and hemoglobin in a general middle-aged population sample were associated with increased long-term risk of VTE, particularly provoked VTE.
Identifiants
pubmed: 32211576
doi: 10.1002/rth2.12325
pii: S2475-0379(22)01995-1
pmc: PMC7086464
doi:
Types de publication
Journal Article
Langues
eng
Pagination
422-428Subventions
Organisme : NHLBI NIH HHS
ID : R01 HL059367
Pays : United States
Informations de copyright
© 2020 The Authors. Research and Practice in Thrombosis and Haemostasis published by Wiley Periodicals, Inc on behalf of International Society on Thrombosis and Haemostasis.
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