Limits...
Hematocrit and the risk of recurrent venous thrombosis: a prospective cohort study.

Eischer L, Tscholl V, Heinze G, Traby L, Kyrle PA, Eichinger S - PLoS ONE (2012)

Bottom Line: Patients with a first VTE were followed after anticoagulation.Patients with VTE provoked by a transient risk factor, natural inhibitor deficiency, lupus anticoagulant, homozygous or double heterozygous defects, cancer, or long-term antithrombotic treatment were excluded.The study endpoint was recurrent VTE. 150 (23%) of 653 patients had recurrence.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine I, Medical University of Vienna, Vienna, Austria.

ABSTRACT

Background: Venous thromboembolism (VTE) is a multicausal disease which recurs. Hematocrit is associated with a thrombotic risk. We aimed to investigate if hematocrit is associated with the recurrence risk.

Methods: Patients with a first VTE were followed after anticoagulation. Patients with VTE provoked by a transient risk factor, natural inhibitor deficiency, lupus anticoagulant, homozygous or double heterozygous defects, cancer, or long-term antithrombotic treatment were excluded. The study endpoint was recurrent VTE.

Results: 150 (23%) of 653 patients had recurrence. Only high hematocrit was significantly associated with recurrence risk [hazard ratio (HR) for 1% hematocrit increase with the third tertile 1.08; 95% CI 1.01-1.15]. No or only a weak association for hematocrits within the first and second tertile was seen (HR 1.03; 95% CI 0.97-1.09, and 1.07; 95% CI 1.00-1.13). Hematocrit was associated with recurrence risk only among women. After five years, the probability of recurrence was 9.9% (95% CI 3.7%-15.7%), 15.6% (95% CI 9.7%-21.2%) and 25.5% (95% CI 15.1%-34.6%) in women, and was 29.2% (95% CI 21.1%-36.5%), 30.1% (95% CI 24.1%-35.7%) and 30.8% (95% CI 22.0%-38.7%) in men for hematocrits in the first, second and third tertile, respectively. Men had a higher recurrence risk (1.9; 95% CI 1.1-2.7; p = 0.03), which dropped by 23.5% after adjustment for hematocrit. Hematocrit was not a significant mediator of the sex-difference in recurrence risk (p = 0.223).

Conclusions: High hematocrit is associated with the recurrence only in women. The different recurrence risk between men and women is possibly partly explained by hematocrit.

Show MeSH

Related in: MedlinePlus

Five-year cumulative recurrence risk as estimated from the Cox regression model in women (left) and men (right) at various hematocrits, adjusted for location of first venous thromboembolism, body mass index, age, factor V Leiden, and smoking status.The gray-shaded area corresponds to the 95% confidence intervals. The histograms at the bottom show the frequency distribution (n = number of patients) of hematocrit in women and men.
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3368845&req=5

pone-0038705-g001: Five-year cumulative recurrence risk as estimated from the Cox regression model in women (left) and men (right) at various hematocrits, adjusted for location of first venous thromboembolism, body mass index, age, factor V Leiden, and smoking status.The gray-shaded area corresponds to the 95% confidence intervals. The histograms at the bottom show the frequency distribution (n = number of patients) of hematocrit in women and men.

Mentions: Hematocrit was significantly higher in men than in women (43.7% vs. 39.7%, p<0.001), and the frequency distribution of hematocrit differed substantially (Figure 1). We therefore hypothesized that the effect of sex on recurrence risk might be explained by the sex-specific hematocrit levels and the relationship between hematocrit and risk of recurrence.


Hematocrit and the risk of recurrent venous thrombosis: a prospective cohort study.

Eischer L, Tscholl V, Heinze G, Traby L, Kyrle PA, Eichinger S - PLoS ONE (2012)

Five-year cumulative recurrence risk as estimated from the Cox regression model in women (left) and men (right) at various hematocrits, adjusted for location of first venous thromboembolism, body mass index, age, factor V Leiden, and smoking status.The gray-shaded area corresponds to the 95% confidence intervals. The histograms at the bottom show the frequency distribution (n = number of patients) of hematocrit in women and men.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3368845&req=5

pone-0038705-g001: Five-year cumulative recurrence risk as estimated from the Cox regression model in women (left) and men (right) at various hematocrits, adjusted for location of first venous thromboembolism, body mass index, age, factor V Leiden, and smoking status.The gray-shaded area corresponds to the 95% confidence intervals. The histograms at the bottom show the frequency distribution (n = number of patients) of hematocrit in women and men.
Mentions: Hematocrit was significantly higher in men than in women (43.7% vs. 39.7%, p<0.001), and the frequency distribution of hematocrit differed substantially (Figure 1). We therefore hypothesized that the effect of sex on recurrence risk might be explained by the sex-specific hematocrit levels and the relationship between hematocrit and risk of recurrence.

Bottom Line: Patients with a first VTE were followed after anticoagulation.Patients with VTE provoked by a transient risk factor, natural inhibitor deficiency, lupus anticoagulant, homozygous or double heterozygous defects, cancer, or long-term antithrombotic treatment were excluded.The study endpoint was recurrent VTE. 150 (23%) of 653 patients had recurrence.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine I, Medical University of Vienna, Vienna, Austria.

ABSTRACT

Background: Venous thromboembolism (VTE) is a multicausal disease which recurs. Hematocrit is associated with a thrombotic risk. We aimed to investigate if hematocrit is associated with the recurrence risk.

Methods: Patients with a first VTE were followed after anticoagulation. Patients with VTE provoked by a transient risk factor, natural inhibitor deficiency, lupus anticoagulant, homozygous or double heterozygous defects, cancer, or long-term antithrombotic treatment were excluded. The study endpoint was recurrent VTE.

Results: 150 (23%) of 653 patients had recurrence. Only high hematocrit was significantly associated with recurrence risk [hazard ratio (HR) for 1% hematocrit increase with the third tertile 1.08; 95% CI 1.01-1.15]. No or only a weak association for hematocrits within the first and second tertile was seen (HR 1.03; 95% CI 0.97-1.09, and 1.07; 95% CI 1.00-1.13). Hematocrit was associated with recurrence risk only among women. After five years, the probability of recurrence was 9.9% (95% CI 3.7%-15.7%), 15.6% (95% CI 9.7%-21.2%) and 25.5% (95% CI 15.1%-34.6%) in women, and was 29.2% (95% CI 21.1%-36.5%), 30.1% (95% CI 24.1%-35.7%) and 30.8% (95% CI 22.0%-38.7%) in men for hematocrits in the first, second and third tertile, respectively. Men had a higher recurrence risk (1.9; 95% CI 1.1-2.7; p = 0.03), which dropped by 23.5% after adjustment for hematocrit. Hematocrit was not a significant mediator of the sex-difference in recurrence risk (p = 0.223).

Conclusions: High hematocrit is associated with the recurrence only in women. The different recurrence risk between men and women is possibly partly explained by hematocrit.

Show MeSH
Related in: MedlinePlus