Activated Partial Thromboplastin Time and Risk of Future Venous Thromboembolism
Lower activated partial thromboplastin times are associated with higher levels of some coagulation factors and may represent a procoagulant tendency. In the Atherosclerosis Risk in Communities study, we studied the 13-year risk of venous thromboembolism in relation to baseline activated partial thro...
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| Published in | The American journal of medicine Vol. 121; no. 3; pp. 231 - 238 |
|---|---|
| Main Authors | , , , , |
| Format | Journal Article |
| Language | English |
| Published |
New York, NY
Elsevier Inc
01.03.2008
Elsevier Elsevier Sequoia S.A |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0002-9343 1555-7162 1555-7162 |
| DOI | 10.1016/j.amjmed.2007.10.025 |
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| Abstract | Lower activated partial thromboplastin times are associated with higher levels of some coagulation factors and may represent a procoagulant tendency.
In the Atherosclerosis Risk in Communities study, we studied the 13-year risk of venous thromboembolism in relation to baseline activated partial thromboplastin time in 13,880 individuals. We also studied 258 venous thromboembolism cases and 589 matched controls with measurements of additional coagulation factors.
After adjustment for demographics and procoagulant factors reflected in the activated partial thromboplastin time (fibrinogen, factors VIII, IX, and XI, and von Willebrand factor), participants in the lowest 2 quartiles of activated partial thromboplastin time compared with the fourth quartile had 2.4-fold (95% confidence interval [CI], 1.4-4.2) and 1.9-fold (95% CI, 1.1-3.2) higher risks of venous thromboembolism. The risk associated with activated partial thromboplastin times below the median was higher for idiopathic (odds ratio 5.5; 95% CI, 2.0-15.5) than secondary venous thromboembolism (odds ratio 1.74; 95% CI, 0.88-3.43). Subjects with both activated partial thromboplastin times below the median and factor V Leiden were 12.6-fold (95% CI, 5.7-28.0) more likely to develop venous thromboembolism compared with those with neither risk factor (
P interaction
<.01). A lower activated partial thromboplastin time also added to the thrombosis risk associated with obesity and elevated D-dimer.
A single determination of the activated partial thromboplastin time below the median increased the risk of future venous thromboembolism. Findings were independent of coagulation factor levels, and a low activated partial thromboplastin time added to the risk associated with other risk factors. |
|---|---|
| AbstractList | Lower activated partial thromboplastin times are associated with higher levels of some coagulation factors and may represent a procoagulant tendency.
In the Atherosclerosis Risk in Communities study, we studied the 13-year risk of venous thromboembolism in relation to baseline activated partial thromboplastin time in 13,880 individuals. We also studied 258 venous thromboembolism cases and 589 matched controls with measurements of additional coagulation factors.
After adjustment for demographics and procoagulant factors reflected in the activated partial thromboplastin time (fibrinogen, factors VIII, IX, and XI, and von Willebrand factor), participants in the lowest 2 quartiles of activated partial thromboplastin time compared with the fourth quartile had 2.4-fold (95% confidence interval [CI], 1.4-4.2) and 1.9-fold (95% CI, 1.1-3.2) higher risks of venous thromboembolism. The risk associated with activated partial thromboplastin times below the median was higher for idiopathic (odds ratio 5.5; 95% CI, 2.0-15.5) than secondary venous thromboembolism (odds ratio 1.74; 95% CI, 0.88-3.43). Subjects with both activated partial thromboplastin times below the median and factor V Leiden were 12.6-fold (95% CI, 5.7-28.0) more likely to develop venous thromboembolism compared with those with neither risk factor (
P interaction
<.01). A lower activated partial thromboplastin time also added to the thrombosis risk associated with obesity and elevated D-dimer.
A single determination of the activated partial thromboplastin time below the median increased the risk of future venous thromboembolism. Findings were independent of coagulation factor levels, and a low activated partial thromboplastin time added to the risk associated with other risk factors. Lower activated partial thromboplastin times are associated with higher levels of some coagulation factors and may represent a procoagulant tendency.BACKGROUNDLower activated partial thromboplastin times are associated with higher levels of some coagulation factors and may represent a procoagulant tendency.In the Atherosclerosis Risk in Communities study, we studied the 13-year risk of venous thromboembolism in relation to baseline activated partial thromboplastin time in 13,880 individuals. We also studied 258 venous thromboembolism cases and 589 matched controls with measurements of additional coagulation factors.METHODSIn the Atherosclerosis Risk in Communities study, we studied the 13-year risk of venous thromboembolism in relation to baseline activated partial thromboplastin time in 13,880 individuals. We also studied 258 venous thromboembolism cases and 589 matched controls with measurements of additional coagulation factors.After adjustment for demographics and procoagulant factors reflected in the activated partial thromboplastin time (fibrinogen, factors VIII, IX, and XI, and von Willebrand factor), participants in the lowest 2 quartiles of activated partial thromboplastin time compared with the fourth quartile had 2.4-fold (95% confidence interval [CI], 1.4-4.2) and 1.9-fold (95% CI, 1.1-3.2) higher risks of venous thromboembolism. The risk associated with activated partial thromboplastin times below the median was higher for idiopathic (odds ratio 5.5; 95% CI, 2.0-15.5) than secondary venous thromboembolism (odds ratio 1.74; 95% CI, 0.88-3.43). Subjects with both activated partial thromboplastin times below the median and factor V Leiden were 12.6-fold (95% CI, 5.7-28.0) more likely to develop venous thromboembolism compared with those with neither risk factor (P interaction<.01). A lower activated partial thromboplastin time also added to the thrombosis risk associated with obesity and elevated D-dimer.RESULTSAfter adjustment for demographics and procoagulant factors reflected in the activated partial thromboplastin time (fibrinogen, factors VIII, IX, and XI, and von Willebrand factor), participants in the lowest 2 quartiles of activated partial thromboplastin time compared with the fourth quartile had 2.4-fold (95% confidence interval [CI], 1.4-4.2) and 1.9-fold (95% CI, 1.1-3.2) higher risks of venous thromboembolism. The risk associated with activated partial thromboplastin times below the median was higher for idiopathic (odds ratio 5.5; 95% CI, 2.0-15.5) than secondary venous thromboembolism (odds ratio 1.74; 95% CI, 0.88-3.43). Subjects with both activated partial thromboplastin times below the median and factor V Leiden were 12.6-fold (95% CI, 5.7-28.0) more likely to develop venous thromboembolism compared with those with neither risk factor (P interaction<.01). A lower activated partial thromboplastin time also added to the thrombosis risk associated with obesity and elevated D-dimer.A single determination of the activated partial thromboplastin time below the median increased the risk of future venous thromboembolism. Findings were independent of coagulation factor levels, and a low activated partial thromboplastin time added to the risk associated with other risk factors.CONCLUSIONA single determination of the activated partial thromboplastin time below the median increased the risk of future venous thromboembolism. Findings were independent of coagulation factor levels, and a low activated partial thromboplastin time added to the risk associated with other risk factors. Lower activated partial thromboplastin times are associated with higher levels of some coagulation factors and may represent a procoagulant tendency. In the Atherosclerosis Risk in Communities study, we studied the 13-year risk of venous thromboembolism in relation to baseline activated partial thromboplastin time in 13,880 individuals. We also studied 258 venous thromboembolism cases and 589 matched controls with measurements of additional coagulation factors. After adjustment for demographics and procoagulant factors reflected in the activated partial thromboplastin time (fibrinogen, factors VIII, IX, and XI, and von Willebrand factor), participants in the lowest 2 quartiles of activated partial thromboplastin time compared with the fourth quartile had 2.4-fold (95% confidence interval [CI], 1.4-4.2) and 1.9-fold (95% CI, 1.1-3.2) higher risks of venous thromboembolism. The risk associated with activated partial thromboplastin times below the median was higher for idiopathic (odds ratio 5.5; 95% CI, 2.0-15.5) than secondary venous thromboembolism (odds ratio 1.74; 95% CI, 0.88-3.43). Subjects with both activated partial thromboplastin times below the median and factor V Leiden were 12.6-fold (95% CI, 5.7-28.0) more likely to develop venous thromboembolism compared with those with neither risk factor (P interaction<.01). A lower activated partial thromboplastin time also added to the thrombosis risk associated with obesity and elevated D-dimer. A single determination of the activated partial thromboplastin time below the median increased the risk of future venous thromboembolism. Findings were independent of coagulation factor levels, and a low activated partial thromboplastin time added to the risk associated with other risk factors. Lower activated partial thromboplastin times are associated with higher levels of some coagulation factors and may represent a procoagulant tendency. In the Atherosclerosis Risk in Communities study, we studied the 13-year risk of venous thromboembolism in relation to baseline activated partial thromboplastin time in 13,880 individuals. We also studied 258 venous thromboembolism cases and 589 matched controls with measurements of additional coagulation factors. After adjustment for demographics and procoagulant factors reflected in the activated partial thromboplastin time (fibrinogen, factors VIII, IX, and XI, and von Willebrand factor), participants in the lowest 2 quartiles of activated partial thromboplastin time compared with the fourth quartile had 2.4-fold (95% confidence interval [CI], 1.4-4.2) and 1.9-fold (95% CI, 1.1-3.2) higher risks of venous thromboembolism. The risk associated with activated partial thromboplastin times below the median was higher for idiopathic (odds ratio 5.5; 95% CI, 2.0-15.5) than secondary venous thromboembolism (odds ratio 1.74; 95% CI, 0.88-3.43). Subjects with both activated partial thromboplastin times below the median and factor V Leiden were 12.6-fold (95% CI, 5.7-28.0) more likely to develop venous thromboembolism compared with those with neither risk factor (P interaction < .01). A lower activated partial thromboplastin time also added to the thrombosis risk associated with obesity and elevated D-dimer. A single determination of the activated partial thromboplastin time below the median increased the risk of future venous thromboembolism. Findings were independent of coagulation factor levels, and a low activated partial thromboplastin time added to the risk associated with other risk factors. Abstract Background Lower activated partial thromboplastin times are associated with higher levels of some coagulation factors and may represent a procoagulant tendency. Methods In the Atherosclerosis Risk in Communities study, we studied the 13-year risk of venous thromboembolism in relation to baseline activated partial thromboplastin time in 13,880 individuals. We also studied 258 venous thromboembolism cases and 589 matched controls with measurements of additional coagulation factors. Results After adjustment for demographics and procoagulant factors reflected in the activated partial thromboplastin time (fibrinogen, factors VIII, IX, and XI, and von Willebrand factor), participants in the lowest 2 quartiles of activated partial thromboplastin time compared with the fourth quartile had 2.4-fold (95% confidence interval [CI], 1.4-4.2) and 1.9-fold (95% CI, 1.1-3.2) higher risks of venous thromboembolism. The risk associated with activated partial thromboplastin times below the median was higher for idiopathic (odds ratio 5.5; 95% CI, 2.0-15.5) than secondary venous thromboembolism (odds ratio 1.74; 95% CI, 0.88-3.43). Subjects with both activated partial thromboplastin times below the median and factor V Leiden were 12.6-fold (95% CI, 5.7-28.0) more likely to develop venous thromboembolism compared with those with neither risk factor ( P interaction <.01). A lower activated partial thromboplastin time also added to the thrombosis risk associated with obesity and elevated D-dimer. Conclusion A single determination of the activated partial thromboplastin time below the median increased the risk of future venous thromboembolism. Findings were independent of coagulation factor levels, and a low activated partial thromboplastin time added to the risk associated with other risk factors. |
| Author | Ohira, Tetsuya White, Richard Folsom, Aaron R. Zakai, Neil A. Cushman, Mary |
| AuthorAffiliation | 5 Department of Medicine, University of Vermont, Burlington 2 Division of Epidemiology and Community Health, University of Minnesota, Minneapolis 1 Department of Medicine, Brown University Providence, RI 3 Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka Medical Center, Osaka, Japan 4 Department of Medicine, University of California Davis Medical Center, Sacramento |
| AuthorAffiliation_xml | – name: 1 Department of Medicine, Brown University Providence, RI – name: 5 Department of Medicine, University of Vermont, Burlington – name: 3 Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka Medical Center, Osaka, Japan – name: 2 Division of Epidemiology and Community Health, University of Minnesota, Minneapolis – name: 4 Department of Medicine, University of California Davis Medical Center, Sacramento |
| Author_xml | – sequence: 1 givenname: Neil A. surname: Zakai fullname: Zakai, Neil A. organization: Department of Medicine, Brown University and Boston University, Providence, RI – sequence: 2 givenname: Tetsuya surname: Ohira fullname: Ohira, Tetsuya organization: Division of Epidemiology and Community Health, University of Minnesota, Minn – sequence: 3 givenname: Richard surname: White fullname: White, Richard organization: Department of Medicine, University of California Davis Medical Center, Sacramento – sequence: 4 givenname: Aaron R. surname: Folsom fullname: Folsom, Aaron R. organization: Division of Epidemiology and Community Health, University of Minnesota, Minn – sequence: 5 givenname: Mary surname: Cushman fullname: Cushman, Mary email: mary.cushman@uvm.edu organization: Department of Medicine, University of Vermont, Burlington |
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| Keywords | Activated partial thromboplastin time Epidemiology Risk factors Venous thromboembolism Coagulation Vascular disease Medicine Risk factor Partial thromboplastin time Deep vein thrombosis Cardiovascular disease Risk Venous thrombosis Thromboembolism Venous disease |
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| Snippet | Lower activated partial thromboplastin times are associated with higher levels of some coagulation factors and may represent a procoagulant tendency.
In the... Abstract Background Lower activated partial thromboplastin times are associated with higher levels of some coagulation factors and may represent a procoagulant... Lower activated partial thromboplastin times are associated with higher levels of some coagulation factors and may represent a procoagulant tendency. In the... Lower activated partial thromboplastin times are associated with higher levels of some coagulation factors and may represent a procoagulant... |
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| SubjectTerms | Activated partial thromboplastin time Biological and medical sciences Coagulation Cohort Studies Epidemiology Female General aspects Humans Internal Medicine Male Medical sciences Middle Aged Partial Thromboplastin Time Public health. Hygiene Public health. Hygiene-occupational medicine Risk Factors United States - epidemiology Vein & artery diseases Venous thromboembolism Venous Thromboembolism - blood Venous Thromboembolism - epidemiology |
| Title | Activated Partial Thromboplastin Time and Risk of Future Venous Thromboembolism |
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