Haematological variables and risk of future venous thromboembolism in the British Regional Heart Study on men. Combined D-dimer and APTT as a predictive test for thromboembolism?

Abstract	We examined the associations between haematological and inflammatory variables with future venous thromboembolism (VTE), in 3494 men aged 60-79 years, with no previous history of VTE or myocardial infarction, who were not receiving oral anticoagulants. After a mean follow-up period of 18 years, there were 149 confirmed cases of fatal or non-fatal VTE (deep vein thrombosis and/or pulmonary embolism). Among classical cardiovascular risk factors, only obesity and cigarette smoking were associated with VTE risk. After adjustment for age, obesity and smoking, VTE risk was associated with coagulation factor VIII, factor IX, von Willebrand factor (VWF), activated partial thromboplastin time (APTT), and fibrin D-dimer. Hazard ratios (95% CI) for top to bottom quarters (bottom to top for APTT), were respectively 2.17 (1.37, 3.44), 2.15 (1.30, 3.53), 2.02 (1.27, 3.22), 2.43 (1.47, 4.02) and 3.62 (2.18, 6.08). The 11% of men with both the shortest APTT and highest D-dimer combined had a 5.02 (2.37, 10.62) higher risk of VTE. VTE risk was not associated with fibrinogen, factor VII or activated protein C resistance; full blood count variables or with inflammatory markers, plasma viscosity, C-reactive protein or interleukin-6. The combination of D-dimer and APTT merits evaluation as an adjunct to VTE risk prediction scores.
Authors	S Goya Wannamethee, Olia Papacosta, Lucy Lennon, Peter H Whincup, Ann Rumley, Gordon D O Lowe
Journal	British journal of haematology (Br J Haematol) Vol. 198 Issue 3 Pg. 587-594 (08 2022) ISSN: 1365-2141 [Electronic] England
PMID	35655415 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Copyright	© 2022 The Authors. British Journal of Haematology published by British Society for Haematology and John Wiley & Sons Ltd.
Chemical References	Biomarkers Fibrin Fibrinogen Degradation Products fibrin fragment D
Topics	Biomarkers Fibrin Fibrinogen Degradation Products (chemistry) Humans Male Obesity Partial Thromboplastin Time Risk Factors Venous Thromboembolism (diagnosis, epidemiology, etiology)

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