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Previous Volume 348:1435-1441 April 10, 2003 Number 15 Next

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ABSTRACT

Background In about a third of patients with venous thromboembolism, the cause of the disorder is unexplained. In patients with atherosclerosis, activation of both platelets and blood coagulation and an increase in fibrin turnover are detectable, which may lead to thrombotic complications. Whether atherosclerosis is associated with an increased risk of venous thrombosis is unknown.

Methods We performed ultrasonography of the carotid arteries in 299 unselected patients who had deep venous thrombosis of the legs without symptomatic atherosclerosis and in 150 control subjects. Patients with spontaneous thrombosis, patients with secondary thrombosis from acquired risk factors, and control subjects were assessed for plaques.

Results At least one carotid plaque was detected in 72 of the 153 patients with spontaneous thrombosis (47.1 percent; 95 percent confidence interval, 39.1 to 55.0), 40 of the 146 with secondary thrombosis (27.4 percent; 95 percent confidence interval, 20.2 to 34.6), and 48 of the 150 control subjects (32.0 percent; 95 percent confidence interval, 24.5 to 39.5). The odds ratios for carotid plaques in patients with spontaneous thrombosis, as compared with patients with secondary thrombosis and with controls, were 2.3 (95 percent confidence interval, 1.4 to 3.7) and 1.8 (95 percent confidence interval, 1.1 to 2.9), respectively. In a multivariate analysis that accounted for risk factors for atherosclerosis, the strength of this association did not change.

Conclusions There is an association between atherosclerotic disease and spontaneous venous thrombosis. Atherosclerosis may induce venous thrombosis, or the two conditions may share common risk factors.

Source Information

From the Department of Medical and Surgical Sciences, Second Chair of Internal Medicine, University of Padua Medical School, Padua, Italy (P.P., F.B., A.M., E.B., F.P., A.G.); the Center for Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam (A.W.A.L.); and the Department of Clinical Epidemiology, University of Maastricht, Maastricht, the Netherlands (M.H.P.).

Address reprint requests to Dr. Prandoni at the Department of Medical and Surgical Sciences, Second Chair of Internal Medicine, University of Padua, Via Ospedale Civile 105, 35128 Padua, Italy, or at paoprand{at}tin.it.

Full Text of this Article

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An Association between Atherosclerosis and Venous Thrombosis
Duggirala M. K., Cook D. A., Mauck K. F., Tai Y. F., Prandoni P., Lensing A. W.A., Prins M. H.
Extract | Full Text | PDF  
N Engl J Med 2003; 349:401-402, Jul 24, 2003. Correspondence

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