Venous thromboembolism in association with features of the metabolic syndrome.
BACKGROUND
Central obesity, diabetes mellitus, dyslipidaemia and chronic hypertension--features of the metabolic syndrome--have been individually associated with venous thromboembolism (VTE). However, whether each of these factors additively increases the risk of VTE is uncertain.


OBJECTIVE
To determine whether features of the metabolic syndrome independently increase the risk of VTE.


METHODS
Prospective cohort study derived from the Heart Outcomes Prevention Evaluation 2 (HOPE-2) randomized clinical trial.


METHODS
One hundred and forty-five clinical centres in 13 countries.


METHODS
We studied 5522 adults aged > or =55 years with cardiovascular disease or diabetes mellitus. At enrollment, 35% had 0-1 features of the metabolic syndrome, 30% had two, 24% had three and 11% had four. We defined symptomatic VTE as an objectively confirmed new episode of deep-vein thrombosis or pulmonary embolism.


RESULTS
VTE occurred in 88 individuals during a median 5.0 years of follow-up. The incidence rate of VTE (per 100 person-years) was 0.30 with 0-1 features, 0.36 with two features, 0.38 with three features and 0.40 with four features of the metabolic syndrome (trend p = 0.43). Relative to the presence of 0-1 features of the metabolic syndrome, the adjusted hazard ratio (95%CI) for VTE was 1.22 (0.71-2.08) with two features, 1.25 (0.70-2.24) with three features, and 1.26 (0.59-2.69) with four features.


CONCLUSIONS
The number of features of the metabolic syndrome present was not a clinically important risk factor for VTE in older adults with vascular arterial disease.
Ray
J G
JG
Department of Medicine, St. Michael's Hospital, University of Toronto, Ontario M5B 1W8, Canada. rayj@smh.toronto.on.ca
Lonn
E
E
Yi
Q
Q
Rathe
A
A
Sheridan
P
P
Kearon
C
C
Yusuf
S
S
Arnold
M J O
MJ
McQueen
M J
MJ
Pogue
J
J
Probstfield
J
J
Fodor
G
G
Held
C
C
Micks
M
M
Genest
J
J
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D016017:Odds Ratio; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D054556:Venous Thromboembolism / Q000453:epidemiology*; D049629:Waist-Hip Ratio
D001786:Blood Glucose; D014280:Triglycerides