Repeated measurements of carotid atherosclerosis and future risk of venous thromboembolism: the Tromsø Study

B Småbrekke; L B Rinde; E M Hald; I Njølstad; E B Mathiesen; S H Johnsen; J-B Hansen; S K Braekkan; W M Lijfering

doi:10.1111/jth.13858

Repeated measurements of carotid atherosclerosis and future risk of venous thromboembolism: the Tromsø Study

J Thromb Haemost. 2017 Dec;15(12):2344-2351. doi: 10.1111/jth.13858. Epub 2017 Oct 27.

Authors

B Småbrekke¹, L B Rinde¹, E M Hald^{1

2}, I Njølstad^{1

3}, E B Mathiesen^{1

4

5}, S H Johnsen^{4

5}, J-B Hansen^{1

2}, S K Braekkan^{1

2}, W M Lijfering⁶

Affiliations

¹ K. G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
² Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway.
³ Epidemiology of Chronic Diseases Research Group, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
⁴ Brain and Circulation Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
⁵ Department of Neurology, University Hospital of North Norway, Tromsø, Norway.
⁶ Department of Clinical Epidemiology, Leiden University Medical Center, the Netherlands.

PMID: 28981216
DOI: 10.1111/jth.13858

Abstract

Essentials The relationship between atherosclerosis and venous thromboembolism (VTE) is controversial. In total, 10 426 participants recruited from the general population were included. Carotid intima media thickness and total plaque area was not associated with VTE. There was no association between plaque initiation or plaque progression and subsequent VTE.

Summary: Background Whether a relationship between atherosclerosis and subsequent venous thromboembolism (VTE) exists is controversial. Objective To investigate the association between carotid atherosclerosis and VTE by using repeated measurements of intima media thickness (IMT) and total plaque area (TPA) in participants recruited from the general population. Methods Participants were recruited from the fourth (1994-1995), fifth (2001-2002) and sixth (2007-2008) surveys of the Tromsø Study. In total, 10 426 participants attended, for whom measurements of carotid IMT and TPA and potential confounders were updated at each available survey. Time-varying Cox regression models were used to calculate hazard ratios (HRs) of VTE across various levels of IMT and TPA adjusted for age, sex, and body mass index. Results There were 368 incident VTE events during a median follow-up of 10.8 years. Participants with increasing IMT were, on average, older and had a less favorable cardiovascular risk profile. There was no association between tertiles of increasing TPA and the risk of VTE in the time-varying model, and increasing IMT was not associated with an increased risk of VTE (HR 0.96, 95% confidence interval [CI] 0.86-1.07). Neither plaque formation nor plaque progression was associated with the risk of VTE (respectively: HR 1.00, 95% CI 0.98-1.02; and HR 0.96, 95% CI 0.84-1.11). Conclusion Carotid IMT and TPA were not associated with an increased risk of VTE in time-varying analyses. Furthermore, there was no association between plaque initiation or plaque progression and subsequent VTE.

Keywords: atherosclerosis; cohort studies; repeated measurements; risk factors; venous thromboembolism.

MeSH terms

Adult
Aged
Carotid Artery Diseases / complications*
Carotid Artery Diseases / diagnosis
Carotid Artery Diseases / diagnostic imaging
Carotid Intima-Media Thickness
Cohort Studies
Female
Humans
Male
Middle Aged
Norway / epidemiology
Plaque, Atherosclerotic / complications
Plaque, Atherosclerotic / diagnostic imaging
Proportional Hazards Models
Prospective Studies
Risk Factors
Time Factors
Venous Thromboembolism / epidemiology
Venous Thromboembolism / etiology*