Lipid parameters, lipid lowering drugs and the risk of venous thromboembolism.
BACKGROUND
Besides their effects on atherogenesis, lipids and lipoproteins could contribute to the development of venous thromboembolism (VTE). This association has been investigated in a few studies with conflicting results.


METHODS
Plasma levels of total cholesterol, triglycerides, HDL-cholesterol, LDL-cholesterol, apolipoprotein A-I and apolipoprotein B were measured in 467 patients with a first unprovoked VTE event diagnosed between May 2000 and December 2004 and in 467 age and sex matched controls. The association between these parameters and VTE was determined in non-users of lipid lowering drugs (LLD), in statin users and in fibrate users in a quartile-based analysis. We repeated this stratified analysis within each stratum of men and women.


RESULTS
The median age of patients was 73 years [interquartile range 58-80], 41.5% were men. Among the 934 patients of the study, 100 were treated with statin, 91 with fibrate and 743 were not receiving LLD. Among non users of LLD, high levels of apolipoprotein B were associated with VTE (OR 1.82, 95% CI 1.19-2.79) after adjustment for age and body mass index. Elevated LDL-cholesterol levels were associated with VTE only in men (OR 2.32, 95% CI 1.07-5.01). High levels of LDL/HDL-cholesterol and apolipoprotein B/apolipoprotein A-I ratios were associated with VTE (OR 2.76, 95% CI 1.69-4.50 and OR 1.86, 95% CI 1.16-2.97 respectively) but this effect was mainly observed in men. There was no association between lipid parameters and VTE in statin users and in fibrate users.


CONCLUSIONS
Our results are in line with the new concept of a global cardiovascular disease combining atherosclerosis and VTE.
Brest University, GETBO EA 3878, Brest Cedex F-29609, France.
Aurélien
A
Delluc
Jean-Marc
JM
Malécot
Hélène
H
Kerspern
Emmanuel
E
Nowak
Jean-Luc
JL
Carre
Dominique
D
Mottier
Grégoire
G
Le Gal
Karine
K
Lacut
D000368:Aged; D000369:Aged, 80 and over; D016632:Apolipoprotein A-I / Q000097:blood; D001055:Apolipoproteins B / Q000097:blood; D050197:Atherosclerosis / Q000097:blood / Q000150:complications* / Q000188:drug therapy*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D050171:Dyslipidemias / Q000097:blood / Q000150:complications* / Q000188:drug therapy*; D005260:Female; D058607:Fibric Acids / Q000627:therapeutic use*; D005602:France; D006785:Hospitals, University; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008055:Lipids / Q000097:blood*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood; D054556:Venous Thromboembolism / Q000097:blood / Q000209:etiology*
C505693:APOA1 protein, human; D016632:Apolipoprotein A-I; D001055:Apolipoproteins B; D015415:Biomarkers; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D058607:Fibric Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008055:Lipids; D014280:Triglycerides; D002784:Cholesterol