Reduced calf muscle pump function is a risk factor for venous thromboembolism: a population-based cohort study
Autor: | Ramila A. Mehta, Damon E. Houghton, Thom W. Rooke, David O. Hodge, David A. Liedl, Robert D. McBane, Waldemar E. Wysokinski, Aneel A. Ashrani, Paul W Wennberg |
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Rok vydání: | 2021 |
Předmět: |
Male
medicine.medical_specialty BLOOD COMMENTARY Deep vein Immunology Population 030204 cardiovascular system & hematology Biochemistry 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Plethysmograph Risk factor Muscle Skeletal education Aged Aged 80 and over Venous Thrombosis education.field_of_study business.industry Incidence Hazard ratio Models Cardiovascular Venous Thromboembolism Cell Biology Hematology Middle Aged medicine.disease Confidence interval Plethysmography Venous thrombosis medicine.anatomical_structure 030220 oncology & carcinogenesis Cardiology Female business Follow-Up Studies Cohort study |
Zdroj: | Blood |
ISSN: | 1528-0020 0006-4971 |
Popis: | The calf muscle pump is a major determinate of venous return in the legs but has not been studied as a risk factor for venous thromboembolism (VTE). A population-based cohort study of Olmsted County, Minnesota residents was performed using calf pump function (CPF) measurements from venous plethysmography studies from 1998 to 2015. Patients with a history of VTE were excluded. Nursing validated VTE outcomes from the Rochester Epidemiology Project were identified after the index study date, and patients with reduced CPF (rCPF) were compared with patients with normal CPF. A total of 1532 patients with recorded CPF (28% air and 72% strain gauge plethysmography) were included; 591 (38.5%) had normal CPF, 353 (23.0%) had unilateral rCPF, and 588 (38.3%) had bilateral rCPF. Any VTE occurred in 87 patients (5.7%) after a median follow-up of 11.7 years (range, 0-22.0 years). Comparing patients with bilateral reduced to bilateral normal CPF, the unadjusted hazard ratio (HR) for incident VTE was 2.0 (95% confidence interval [CI], 1.2-3.4) and after adjusting for age, BMI, and Charlson Comorbidity Index, the HR was 1.68 (95% CI, 0.98-2.89). The adjusted HR for ipsilateral deep vein thrombosis was evaluated in 3064 legs comparing legs with reduced to normal CPF and was 1.71 (95% CI, 1.03-2.84). Mortality was significantly higher in both the bilateral (P < .001) and unilateral (P < .001) rCPF groups compared with normal CPF. Our results demonstrate that CPF is a risk factor for VTE in an otherwise low-risk ambulatory population and might be a useful component in risk stratification models. |
Databáze: | OpenAIRE |
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