Objective This study aimed at evaluating the effect of thrombophilia on the risk of venous thromboembolism (VTE) in patients undergoing any type of orthopedic surgery.Background Patients undergoing... Show moreObjective This study aimed at evaluating the effect of thrombophilia on the risk of venous thromboembolism (VTE) in patients undergoing any type of orthopedic surgery.Background Patients undergoing orthopedic surgery are at high risk for VTE. Although patients with thrombophilia have an increased risk of VTE, it is currently unclear whether there is a synergetic effect in patients with thrombophilia who undergo orthopedic surgery.Methods Data from a large population-based case-control study (the Multiple Environmental and Genetic Assessment [MEGA] of risk factors for venous thrombosis study) were used. Odds ratios (ORs) with 95% confidence intervals (CIs), adjusted for age, sex, and body mass index (BMI) (ORadj) were calculated for patients undergoing any orthopedic intervention.Results Of 4721 cases and 5638 controls, 263 cases and 94 controls underwent orthopedic surgery. Patients who had any orthopedic intervention in the year before the index date were at higher risk of VTE (ORadj 3.7; 95% CI, 2.9-4.8) than those who did not undergo any orthopedic surgery. There was an additionally increased risk in patients with factor V Leiden (OR 17.5, 95% CI, 4.1-73.6), non-O blood group (OR 11.2; 95% CI, 3.4-34.0), or elevated plasma levels of factor VIII (OR 18.6; 95% CI, 7.4-46.9) all relative to patients without these defects, not undergoing orthopedic surgery.Conclusions Patients with factor V Leiden, high levels of factor VIII, or blood group non-O were found to have a high risk of VTE after orthopedic surgery. Identification of these patients may enable individualized thromboprophylactic treatment to efficiently reduce VTE risk. Show less
We investigated whether pregnancy loss increases the risk of arterial thrombosis in young women. Women (age 18-50 years) with ischaemic stroke (IS) or myocardial infarction (MI) and at least one... Show moreWe investigated whether pregnancy loss increases the risk of arterial thrombosis in young women. Women (age 18-50 years) with ischaemic stroke (IS) or myocardial infarction (MI) and at least one pregnancy were compared for pregnancy loss in a control group. Odds ratios (OR) with 95% confidence intervals (CI), adjusted for matching variables, cardiovascular risk factors, cardiovascular family history and the presence of antiphospholipid antibodies, were calculated for the number of pregnancy losses as well as the type of unsuccessful pregnancy (early miscarriage, late miscarriage and stillbirth). 165 IS cases, 218 MI cases and 743 controls were included. Women with multiple (>= 3) pregnancy loss had a doubled risk of arterial thrombosis (OR 2.37, 95% CI 0.99-5.70) compared with women without pregnancy loss, similarly to women who experienced stillbirth (OR 1.68, 95% CI 0.79-3.55). Both relative risks were higher for IS (OR 3.51, 95% CI 1.08-11.35 and 2.06, 95% CI 0.81-5.23, respectively) than for MI (OR 2.04, 95% CI 0.71-5.86 and 1.04, 95% CI 0.39-2.79). Adjustment for antiphospholipid antibodies did not affect the estimates. Multiple pregnancy loss and stillbirth increases the risk of IS and, to a lesser extent, of MI, even when other cardiovascular risk factors and antiphospholipid antibodies are accounted for. Show less
Visser, M.C.H. de; Minkelen, R. van; Marion, V. van; Heijer, M. den; Eikenboom, J.; Vos, H.L.; ... ; Bertina, R.M. 2013
