title: Subclinical atherosclerosis and the risk of future venous thrombosis in the Cardiovascular Health Study.
abstract: BACKGROUND
  Recent reports have suggested an association of atherosclerosis with risk of venous thrombosis.
  
  
  OBJECTIVE
  To confirm whether subclinical atherosclerosis is a risk factor for venous thrombosis (VT) among men and women age 65 and older.
  
  
  METHODS
  Participants of the Cardiovascular Health Study (n = 4,108) without baseline clinical cardiovascular disease, anticoagulant use or previous VT were followed for a median of 11.7 years after non-invasive assessment of subclinical atherosclerosis using carotid ultrasound (intima-media thickness and presence of plaques), ankle-brachial blood pressure index and electrocardiogram. Each event was classified as idiopathic or secondary. We used Cox proportional hazards regression to estimate the relative risk of overall and idiopathic VT for individuals with and without baseline subclinical atherosclerosis.
  
  
  RESULTS
  There were 133 first time VT events. No subclinical atherosclerosis measures were associated with increased risk of overall or idiopathic VT. The adjusted relative risks of overall and idiopathic VT for presence of any type of subclinical disease were 0.60 (95% confidence interval 0.39-0.91) and 0.32 (0.18-0.59), respectively. Most of this association was explained by an inverse association of high-risk carotid plaques (prevalent in 54% of those at risk) with VT.
  
  
  CONCLUSIONS
  Non-invasively measured subclinical atherosclerosis was not associated with increased risk of overall or idiopathic VT in this observational study. Carotid plaques and arterial events during follow up were inversely associated, a finding that requires further study.
authors.affiliation: Department of Medicine, University of Vermont, Burlington, 05446, USA.
authors.forename: P B
authors.initials: PB
authors.lastname: van der Hagen
authors.forename: A R
authors.initials: AR
authors.lastname: Folsom
authors.forename: N S
authors.initials: NS
authors.lastname: Jenny
authors.forename: S R
authors.initials: SR
authors.lastname: Heckbert
authors.forename: E S
authors.initials: ES
authors.lastname: O'Meara
authors.forename: L M
authors.initials: LM
authors.lastname: Reich
authors.forename: F R
authors.initials: FR
authors.lastname: Rosendaal
authors.forename: M
authors.initials: M
authors.lastname: Cushman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000150:complications* / Q000453:epidemiology; D002341:Carotid Artery Thrombosis / Q000000981:diagnostic imaging; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D016016:Proportional Hazards Models; D012307:Risk Factors; D014463:Ultrasonography; D020246:Venous Thrombosis / Q000453:epidemiology / Q000209:etiology*