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Haematological variables and risk of future venous thromboembolism in the British Regional Heart Study on men. Combined D‐dimer and APTT as a predictive test for thromboembolism?
Author(s) -
Wannamethee S. Goya,
Papacosta Olia,
Len Lucy,
Whincup Peter H.,
Rumley Ann,
Lowe Gordon D. O.
Publication year - 2022
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.18288
Subject(s) - medicine , partial thromboplastin time , pulmonary embolism , risk factor , fibrinogen , von willebrand factor , venous thrombosis , thrombosis , coagulation , deep vein , d dimer , gastroenterology , surgery , platelet
Summary We examined the associations between haematological and inflammatory variables with future venous thromboembolism (VTE), in 3494 men aged 60–79 years, with no previous history of VTE or myocardial infarction, who were not receiving oral anticoagulants. After a mean follow‐up period of 18 years, there were 149 confirmed cases of fatal or non‐fatal VTE (deep vein thrombosis and/or pulmonary embolism). Among classical cardiovascular risk factors, only obesity and cigarette smoking were associated with VTE risk. After adjustment for age, obesity and smoking, VTE risk was associated with coagulation factor VIII, factor IX, von Willebrand factor (VWF), activated partial thromboplastin time (APTT), and fibrin D‐dimer. Hazard ratios (95% CI) for top to bottom quarters (bottom to top for APTT), were respectively 2.17 (1.37, 3.44), 2.15 (1.30, 3.53), 2.02 (1.27, 3.22), 2.43 (1.47, 4.02) and 3.62 (2.18, 6.08). The 11% of men with both the shortest APTT and highest D‐dimer combined had a 5.02 (2.37, 10.62) higher risk of VTE. VTE risk was not associated with fibrinogen, factor VII or activated protein C resistance; full blood count variables or with inflammatory markers, plasma viscosity, C‐reactive protein or interleukin‐6. The combination of D‐dimer and APTT merits evaluation as an adjunct to VTE risk prediction scores.