Impact of Venous Thromboembolism on the Formation and Progression of Carotid Atherosclerosis: The Tromsø Study

Caroline Lind; Birgit Småbrekke; Ludvig Balteskard Rinde; Kristian Hindberg; Ellisiv Bøgeberg Mathiesen; Stein Harald Johnsen; Kjell Arne Arntzen; Inger Njølstad; Willem Lijfering; Sigrid Kufaas Brækkan; John-Bjarne Hansen

doi:10.1055/s-0037-1603983

TH Open, Table of Contents

CC-BY-NC-ND 4.0 · TH Open 2017; 01(01): e66-e72
DOI: 10.1055/s-0037-1603983

Original Article

Georg Thieme Verlag KG Stuttgart · New York

Impact of Venous Thromboembolism on the Formation and Progression of Carotid Atherosclerosis: The Tromsø Study

Caroline Lind

¹K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway

²Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway

,

Birgit Småbrekke

¹K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway

,

Ludvig Balteskard Rinde

¹K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway

,

Kristian Hindberg

¹K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway

,

Ellisiv Bøgeberg Mathiesen

¹K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway

³Brain and Circulation Research Group, Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway

⁴Department of Neurology and Clinical Neurophysiology, University Hospital of North Norway, Tromsø, Norway

,

Stein Harald Johnsen

³Brain and Circulation Research Group, Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway

⁴Department of Neurology and Clinical Neurophysiology, University Hospital of North Norway, Tromsø, Norway

,

Kjell Arne Arntzen

³Brain and Circulation Research Group, Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway

⁴Department of Neurology and Clinical Neurophysiology, University Hospital of North Norway, Tromsø, Norway

,

Inger Njølstad

¹K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway

⁵Epidemiology of Chronic Diseases Research Group, Department of Community Medicine, UiT - The Arctic University of Norway, Tromsø, Norway

,

Willem Lijfering

⁶Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands

,

Sigrid Kufaas Brækkan

¹K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway

²Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway

,

John-Bjarne Hansen

¹K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway

²Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway

› Author Affiliations

Abstract

Venous thromboembolism (VTE) is associated with increased risk of arterial cardiovascular diseases (CVD), and development of atherosclerosis secondary to VTE may be an intermediate between VTE and CVD. Therefore, we aimed to investigate whether incident VTE was associated with subsequent carotid atherosclerosis formation and progression in a population-based observational study. Subjects attending two or more ultrasound examinations of the right carotid artery, with measurement of total plaque area (TPA), in the Tromsø Study in 1994–1995, 2001–2002, and/or 2007–2008 were eligible. We identified 150 subjects diagnosed with first-lifetime VTE between the initial and follow-up visit, and randomly selected 600 age- and sex-matched subjects without VTE between the visits. Subjects with VTE and carotid plaque(s) at the first visit had 4.1 mm² (β: 4.13, 95% CI: −1.72 to 9.98) larger change in TPA between the first and second visit compared with subjects without VTE after adjustment for change in high-sensitivity C-reactive protein (hs-CRP) and traditional atherosclerotic risk factors. The association remained after restricting the analyses to VTE events diagnosed in the first half of the time interval between the carotid ultrasounds (β: 4.02, 95% CI: −3.66 to 11.70), supporting that the change in TPA occurred subsequent to the VTE. No association was found between VTE and novel carotid plaque formation. In conclusion, we found a possible association between VTE and atherosclerosis progression in those with already established carotid plaques, but not between VTE and novel plaque formation. The association between VTE and carotid plaque progression was not mediated by low-grade inflammation assessed by hs-CRP.

Keywords

atherosclerosis - epidemiological studies - risk factors - venous thrombosis

Full Text

References

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