期刊
JOURNAL OF THROMBOSIS AND HAEMOSTASIS
卷 13, 期 1, 页码 2-9出版社
WILEY
DOI: 10.1111/jth.12787
关键词
epidemiology; prospective study; risk factors; sickle cell trait; venous thromboembolism
资金
- National Heart, Lung, and Blood Institute (NHLBI) [R01 HL59367, R01 HL117659, R01 HL087097, U01 HL117659, K12 HL087097]
- ARIC [HHSN268201100005C, HHSN268201100006C, HHSN268 201100007C, HHSN268201100008C, HHSN2682011000 09C, HHSN268201100010C, HHSN268201100011C, HHSN268201100012C]
BackgroundSickle cell trait may increase risk of venous thromboembolism, but this is not fully established. ObjectivesWe sought to determine the association of sickle cell trait with deep vein thrombosis and pulmonary embolism. MethodsMiddle-aged African Americans participating in a prospective, population-based cohort investigation, the Atherosclerosis Risk in Communities Study, were followed from 1987 through 2011 for incident hospitalized pulmonary embolism (n=111) or isolated deep vein thrombosis (n=138), verified by physician review of medical records. Sickle cell trait (heterozygosity for hemoglobin S, n=268) was compared with no sickle cell trait (n=3748). ResultsOver a median of 22years of follow-up, 249 participants had an incident venous thromboembolism. The hazard ratio of venous thromboembolism was 1.50 (95% confidence interval [CI] 0.96-2.36) for participants with vs. without sickle cell trait, after adjustment for age, sex, ancestry, hormone replacement therapy (women), body mass index, diabetes, and estimated glomerular filtration rate. This hazard ratio was 2.05 (95% CI 1.12-3.76) for pulmonary embolism and 1.15 (95% CI 0.58-2.27) for deep vein thrombosis without pulmonary embolism. ConclusionsSickle cell trait in African Americans carries a 2-fold increased risk of pulmonary embolism but does not elevate deep vein thrombosis risk. Because neonatal screening for sickle hemoglobin is being conducted in the United States, consideration should be paid to the increased pulmonary embolism risk of individuals with sickle cell trait.
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