RESEARCH - An Association Between Atherosclerosis and Venous Thrombosis

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

An Association between Atherosclerosis and Venous Thrombosis

Paolo Prandoni, M.D., Ph.D., Franca Bilora, M.D., Marchiori, M.D.,

Enrico Bernardi, M.D., Francesco Petrobelli, M.D., Anthonie W.A. Lensing,

M.D., Ph.D., H. Prins, M.D., Ph.D., and Girolami, M.D.

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.

http://content.nejm.org/cgi/content/abstract/348/15/1435?ijkey=34a208634b63f2a90\

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