Endothelial dysfunction in patients with spontaneous venous thromboembolism.
OBJECTIVE
A high incidence of atherosclerotic lesions and cardiovascular events has been reported in patients with spontaneous venous thromboembolism. Endothelial dysfunction is an early marker of atherosclerosis and has predictive value for ischemic events. We have evaluated endothelial function in patients with a history of spontaneous venous thromboembolism.


METHODS
Patients with a history of symptomatic, objectively confirmed, spontaneous venous thromboembolism were included in a case-control study. Exclusion criteria were any known risk factors for cardiovascular diseases, other conditions associated with endothelial dysfunction, estro-progestinic therapy or pregnancy. Controls were age- (+/-5 years) and sex-matched subjects with the same exclusion criteria but without previous venous thromboembolism. Endothelial function was evaluated by the non-invasive measurement of flow-mediated vasodilation of the brachial artery and of plasma markers of endothelium activation; platelet activation parameters were also measured.


RESULTS
Twenty-eight cases (8 females; mean age 59+/-15 years) and 28 controls (8 females; mean age 58+/-15) were studied. Flow-mediated vasodilation was 3.5+/-0.6% in cases (95% CIs: 2.2 to 4.8) and 5.7+/-0.6% (4.2 to 6.8) in controls (p=0.015). Brachial artery blood flow and hyperemic blood flow did not differ between the two groups. Plasma von Willebrand factor and soluble P-selectin levels were significantly higher in patients with venous thromboembolism, while plasma soluble CD40 ligand and urinary 11-dehydro-TxB2 levels were similar in cases and controls.


CONCLUSIONS
Patients with spontaneous venous thromboembolism have endothelial dysfunction, unlike age- and sex- matched controls. This finding suggests that spontaneous venous thromboembolism may be a condition associated with an enhanced risk of atherosclerosis.
Migliacci
Rino
R
Division of Internal and Cardiovascular Medicine, Department of Internal Medicine, University of Perugia, Perugia, Italy.
Becattini
Cecilia
C
Pesavento
Raffaele
R
Davi
Giovanni
G
Vedovati
Maria Cristina
MC
Guglielmini
Giuseppe
G
Falcinelli
Emanuela
E
Ciabattoni
Giovanni
G
Dalla Valle
Fabio
F
Prandoni
Paolo
P
Agnelli
Giancarlo
G
Gresele
Paolo
P
D000328:Adult; D000368:Aged; D050197:Atherosclerosis; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D013923:Thromboembolism / Q000473:pathology*; D014664:Vasodilation; D020246:Venous Thrombosis / Q000473:pathology*
D015415:Biomarkers