Increased risk and severity of unprovoked venous thromboembolism with clustering cardiovascular risk factors for atherosclerosis: Results of the REMOTEV registry.
BACKGROUND
The role of cardiovascular risk factors (CVRF) for atherosclerosis in venous thromboembolic disease (VTE) is controversial. The aim of this study was to evaluate the impact of CVRF and their cumulative effects on the occurrence of unprovoked VTE, severity, recurrence and survival.


METHODS AND RESULTS
This is a prospective cohort from the REMOTEV registry including all consecutively hospitalized patients for acute symptomatic VTE. From November 2013 to December 2016, 515 patients with 6months follow-up (FU) were selected for the analysis. Events were classified as unprovoked or provoked VTE. In univariate analysis, hypertension (OR 1.44, [95% CI 1.01-2.06]), diabetes (OR 2.07, [95% CI: 1.25-3.55]) and age (OR 1.94, [95% CI: 1.31-2.88]) were significantly associated with the risk of unprovoked VTE. After adjustment, diabetes (OR 1.82, [95% CI: 1.07-3.18]) and age (OR 1.79, [95% CI: 1.15-2.8]) remained associated with the risk of unprovoked VTE. The proportion of unprovoked VTE increased significantly with the number of CVRF adjusted for thrombophilia (1 CVRF: OR 3 [95% CI: 1.44-6.52]) 2 CVRF: OR 4.33 [95% CI: 2.07-9.49] and ≥3 CVRF: OR 4.58 [95% CI: 2.27-9.7]). The severity of pulmonary embolism was significantly associated with CVRF clustering. There were more VTE recurrences and deaths during the 6months of FU with cumulative CVRF.


CONCLUSION
The risks of unprovoked VTE and PE severity are associated with clustering CVRF. The role of cumulative CVRF predominates rather than the specific burden of each of the CVRF in the risk of VTE occurrence.
['Gaertner|S|S|', 'Cordeanu|E-M|EM|', 'Mirea|C|C|', 'Frantz|A-S|AS|', 'Auger|C|C|', 'Bilbault|P|P|', 'Ohlmann|P|P|', 'Schini-Kerth|V|V|', 'Stephan|D|D|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D050197:Atherosclerosis D002318:Cardiovascular Diseases D016000:Cluster Analysis D006801:Humans D008297:Male D008875:Middle Aged D011446:Prospective Studies D012042:Registries D012307:Risk Factors D012720:Severity of Illness Index D054556:Venous Thromboembolism
Unprovoked Venous thromboembolism Cardiovascular risk factors Atherosclerosis