In his PhD thesis, Ludvig Balteskard Rinde has looked at the impact of atherosclerosis, myocardial infarction and ischemic stroke on the risk of venous thromboembolism.
- The risk of venous thromboembolism is substantially increased the first month after both myocardial infarction and ischemic stroke.
- There seems to be no association between atherosclerosis and risk of venous thromboembolism.
- A high genetic risk score for venous thromboembolism is associated with severalfold increased risk in stroke patients.
Thesis:Arterial cardiovascular diseases and risk of venous thromboembolism
Candidate: Ludvig Balteskard Rinde
Time: December 12, 2018 at 12:15
Place: UiT The Arctic University of Norway, MH-Vest: Auditorium Cortex
Link to university website (in Norwegian)
(1) The risk of venous thromboembolism is increased by almost 5-fold the first six months after myocardial infarction. Thereafter, the risk is not significantly increased compared with persons without myocardial infarction. The risk seems to be particularly elevated for pulmonary embolism, and this increased risk lasted for a full year.
The study includes almost 30,000 participant from Tromsø 4, 5 and 6. They were followed until the end of 2010. All analyses were adjusted for several covariates, and the associations were independent of factors such as age, sex, BMI, smoking, diabetes, blood pressure, HDL cholesterol, physical activity and education.
(2) There is a 20-fold increased venous thromboembolism risk the first month after an ischemic stroke. The next couple of months, the risk is still increased by 10-fold, but thereafter the risk increase was only 50 % compared to stroke-free subjects.
The study includes the same population as the study on myocardial infarction. 1360 of the participants had an ischemic stroke during follow-up, and 722 had venous thromboembolism.
(3) Neither carotid atherosclerosis nor plaque progression over time is linked to risk of venous thromboembolism. More than 10,000 participants who had their carotid arteries checked with ultrasound at at least one Tromsø Study between 1994 and 2008 (Tromsø 4, 5 and 6) were included in the analyses. 368 of them had incident venous thromboembolism during a median follow-up of ten years.
(4) In a currently unpublished article, Rinde and co-workers show that genetic risk factors have a large impact on the development of venous thromboemolism after ischemic stroke. The effect was synergistic, and stroke patients with five or more risk alleles had almost twelve times higher risk of venous tromboembolism than participants without stroke and zero or one single risk allele.
The study includes genetic information from 660 Tromsø Study participants who later developed venous thromboembolism, and 1803 age-matched participants without venous thromboembolism. A total of 263 persons had an incident stroke during follow-up, and 60 of them had a venous thromboembolism after the stroke.
(1) Rinde, L. B., Lind, C., Småbrekke, B., Njølstad, I., Mathiesen, E. B., Wilsgaard, T., Brækkan, S., & Hansen, J. B. (2016). Impact of incident myocardial infarction on the risk of venous thromboembolism: the Tromsø Study. Journal of Thrombosis and Haemostasis, 14(6), 1183-1191.
(2) Rinde, L. B., Småbrekke, B., Mathiesen, E. B., Løchen, M. L., Njølstad, I., Hald, E. M., Wilsgaard, T., Brækkan, S. K., & Hansen, J. B. (2016). Ischemic stroke and risk of venous thromboembolism in the general population: the Tromsø Study. Journal of the American Heart Association, 5(11), e004311.
(3) Småbrekke, B., Rinde, L. B., Hald, E. M., Njølstad, I., Mathiesen, E. B., Johnsen, S. H., Hansen, J.-B., Brækkan, S. K., & Lijfering, W. M. (2017). Repeated measurements of carotid atherosclerosis and future risk of venous thromboembolism: the Tromsø Study. Journal of Thrombosis and Haemostasis, 15(12), 2344-2351.
(4) Rinde, L. B., Morelli, V., Småbrekke, B., Mathiesen, E. B., Løchen, M. L., Njølstad, I., Wilsgaard, T., Smith, E., Solomon, T., Rosendaal, F. R., Frazer, K. A., Brækkan, S. K., & Hansen, J. B. Effect of prothrombotic genetic variants on the risk of venous thromboembolism in patients with ischemic stroke. The Tromsø Study. Submitted