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Is there a link between venous and arterial thrombosis? A reappraisal

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Abstract

Whether there is a link between venous and arterial thrombotic disorders is still a matter of debate. They share common risk factors, such as old age, male sex and obesity. Endothelial dysfunction and inflammation are likely to play a role in determining the simultaneous involvement of the two vascular compartments. Unlike subclinical atherosclerosis, symptomatic complications of atherosclerosis such as myocardial infarction, ischemic stroke and atrial fibrillation are likely to predict the subsequent development of venous thromboembolic (VTE) complications. Patients with VTE, especially those with apparently unprovoked episodes, have a definitely increased risk of subsequent arterial thrombotic disorders. Drugs that reduce the risk of arterial thrombosis are likely to reduce the risk of venous thrombosis and vice versa. In particular, the direct oral anticoagulants have recently been shown to reduce the risk of both vascular disorders. In conclusion, recent evidence provides compelling evidence in support of the link between venous and arterial thrombosis. Future studies are needed to clarify the nature of this association, to assess its extent, and to evaluate its implications for clinical practice.

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References

  1. Prandoni P, Bilora F, Marchiori A et al (2003) An association between atherosclerosis and venous thrombosis. N Engl J Med 348(15):1435–1441

    Article  PubMed  Google Scholar 

  2. Prandoni P, Piovella C, Pesavento R (2012) Venous thromboembolism and arterial complications. Semin Respir Crit Care Med 33(2):205–210

    Article  PubMed  Google Scholar 

  3. Ageno W, Becattini C, Brighton T, Selby R, Kamphuisen PW (2008) Cardiovascular risk factors and venous thromboembolism: a meta-analysis. Circulation 117(1):93–102

    Article  PubMed  Google Scholar 

  4. Mahmoodi BK, Cushman M, Anne Næss I et al (2017) Association of traditional cardiovascular risk factors with venous thromboembolism: an individual participant data meta-analysis of prospective studies. Circulation 135(1):7–16

    Article  PubMed  Google Scholar 

  5. Roshani S, Lijfering WM, Coppens M et al (2011) Risk factors of arterial cardiovascular complications in patients with prior venous thromboembolism. Neth J Med 69(1):27–30

    CAS  PubMed  Google Scholar 

  6. Wattanakit K, Lutsey PL, Bell EJ et al (2012) Association between cardiovascular disease risk factors and occurrence of venous thromboembolism. A time-dependent analysis. Thromb Haemost 108(3):508–515

    CAS  PubMed  PubMed Central  Google Scholar 

  7. Gregson J, Kaptoge S, Bolton T et al (2019) Cardiovascular risk factors associated with venous thromboembolism. JAMA Cardiol 4(2):163–173

    Article  PubMed  Google Scholar 

  8. Migliacci R, Becattini C, Pesavento R et al (2007) Endothelial dysfunction in patients with spontaneous venous thromboembolism. Haematologica 92(6):812–818

    Article  CAS  PubMed  Google Scholar 

  9. Mahmoodi BK, Gansevoort RT, Veeger NJ et al (2009) Microalbuminuria and risk of venous thromboembolism. JAMA 301(17):1790–1797

    Article  CAS  PubMed  Google Scholar 

  10. Simes J, Robledo KP, White HD et al (2018) D-Dimer predicts long-term cause-specific mortality, cardiovascular events, and cancer in patients with stable coronary heart disease. Circulation 138(7):712–723

    Article  CAS  PubMed  Google Scholar 

  11. Reich LM, Folsom AR, Key NS et al (2006) Prospective study of subclinical atherosclerosis as a risk factor for venous thromboembolism. J Thromb Haemost 4(9):1909–1913

    Article  CAS  PubMed  Google Scholar 

  12. van der Hagen PB, Folsom AR, Jenny NS et al (2006) Subclinical atherosclerosis and the risk of future venous thrombosis in the Cardiovascular Health Study. J Thromb Haemost 4(9):1903–1908

    Article  PubMed  Google Scholar 

  13. Småbrekke B, Rinde LB, Hald EM et al (2017) Repeated measurements of carotid atherosclerosis and future risk of venous thromboembolism: the Tromsø Study. J Thromb Haemost 15(12):2344–2351

    Article  PubMed  Google Scholar 

  14. Sørensen HT, Horvath-Puho E, Søgaard KK et al (2009) Arterial cardiovascular events, statins, low-dose aspirin and subsequent risk of venous thromboembolism: a population-based case-control study. J Thromb Haemost 7(4):521–528

    Article  PubMed  Google Scholar 

  15. Cavallari I, Morrow DA, Creager MA et al (2018) Frequency, predictors, and impact of combined antiplatelet therapy on venous thromboembolism in patients with symptomatic atherosclerosis. Circulation 137(7):684–692

    Article  PubMed  Google Scholar 

  16. Lutsey PL, Norby FL, Alonso A et al (2018) Atrial fibrillation and venous thromboembolism: evidence of bidirectionality in the Atherosclerosis Risk in Communities Study. J Thromb Haemost 16(4):670–679

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Prandoni P, Ghirarduzzi A, Prins MH et al (2006) Venous thromboembolism and the risk of subsequent symptomatic atherosclerosis. J Thromb Haemost 4(9):1891–1896

    Article  CAS  PubMed  Google Scholar 

  18. Sørensen HT, Horvath-Puho E, Pedersen L, Baron JA, Prandoni P (2007) Venous thromboembolism and subsequent hospitalization due to acute arterial cardiovascular events—a 20 year cohort study. Lancet 370(9601):1773–1779

    Article  PubMed  Google Scholar 

  19. Spencer FA, Ginsberg JS, Chong A, Alter DA (2008) The relationship between unprovoked venous thromboembolism, age, and acute myocardial infarction. J Thromb Haemost 6(9):1507–1513

    CAS  PubMed  Google Scholar 

  20. Klok FA, Mos IC, Broek L et al (2009) Risk of arterial cardiovascular events in patients after pulmonary embolism. Blood 114(8):1484–1488

    Article  CAS  PubMed  Google Scholar 

  21. Becattini C, Vedovati M, Ageno W, Dentali F, Agnelli G (2010) Incidence of arterial cardiovascular events after venous thromboembolism. A systematic review and a meta-analysis. J Thromb Haemost 8(5):891–897

    CAS  PubMed  Google Scholar 

  22. Chang WT, Chang CL, Ho CH, Hong CS, Wang JJ, Chen ZC (2017) Long-term effects of unprovoked venous thromboembolism on mortality and major cardiovascular events. J Am Heart Assoc 6:e005466

    Article  PubMed  PubMed Central  Google Scholar 

  23. Prandoni P, Lensing AW, Prins MH et al (2015) The impact of residual thrombosis on the long-term outcome of patients with deep venous thrombosis treated with conventional anticoagulation. Semin Thromb Hemost 41(2):133–140

    Article  CAS  PubMed  Google Scholar 

  24. Kunutsor SK, Seidu S, Khunti K (2017) Statins and primary prevention of venous thromboembolism: a systematic review and meta-analysis. Lancet Haematol 4(2):e83–e93

    Article  PubMed  Google Scholar 

  25. Simes J, Becattini C, Agnelli G et al (2014) Aspirin for the prevention of recurrent venous thromboembolism: the INSPIRE collaboration. Circulation 130(13):1062–1071

    Article  CAS  PubMed  Google Scholar 

  26. Gibson CM, Chi G, Halaby R et al (2017) Extended-duration betrixaban reduces the risk of stroke versus standard-dose enoxaparin among hospitalized medically ill patients: an APEX trial substudy. Circulation 135(7):648–655

    Article  CAS  PubMed  Google Scholar 

  27. Eikelboom JW, Connolly SJ, Bosch J et al (2017) Rivaroxaban with or without aspirin in stable cardiovascular disease. N Engl J Med 377(14):1319–1330

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Paolo Prandoni.

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Prandoni, P. Is there a link between venous and arterial thrombosis? A reappraisal. Intern Emerg Med 15, 33–36 (2020). https://doi.org/10.1007/s11739-019-02238-6

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