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J Thromb Haemost. 2009 Apr;7(4):588-96. doi: 10.1111/j.1538-7836.2009.03302.x. Epub 2009 Jan 24.

Lipid biomarkers, hormone therapy and the risk of venous thromboembolism in women.

Author information

  • 1The Center for Cardiovascular Disease Prevention, Harvard Medical School, and the Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02215, USA. beverett@partners.org

Abstract

BACKGROUND:

Published reports of a relationship between lipids and incident venous thromboembolism (VTE) are conflicting.

OBJECTIVES:

To clarify the relationship between lipids and VTE risk in healthy women, including potential effect modification by hormone therapy (HT).

PATIENTS/METHODS:

Among 27 081 initially healthy women followed prospectively for incident VTE, we measured a full panel of lipid biomarkers, including total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides and apolipoproteins A-I (apo A-I) and B(100).

RESULTS:

During a median follow-up of 11.4 years, VTE occurred in 355 women. We observed no relationship between any of the lipids and VTE risk. However, when unprovoked VTE was considered separately (n=161), both HDL-C and apo A-I were positively associated with risk. Fully adjusted hazard ratios (HR) and 95% confidence intervals (CI) for extreme tertiles of HDL-C and apo A-I were 1.75 (1.13-2.73) and 1.70 (1.10-2.62), respectively. After stratifying by HT use, this relationship was present only among HT users; the HRs for unprovoked VTE for extreme tertiles of HDL-C and apo A-I were 3.58 (1.69-7.58) and 2.88 (1.29-6.42) among users, but only 0.79 (0.39-1.62) and 0.89 (0.50-1.57) among non-users. The interactions were statistically significant (each Pinteraction<0.05).

CONCLUSIONS:

We observed little evidence that lipid levels predict risk of incident VTE among non-users of HT. High levels of HDL-C and apo A-I associate with unprovoked VTE risk among HT users. This observation likely reflects prothrombotic effects of HT that are concomitant with HDL-C and apo A-I levels, rather than direct effects of those lipids.

PMID:
19187075
[PubMed - indexed for MEDLINE]
PMCID:
PMC2694669
Free PMC Article
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