Determinants of Venous Thromboembolism in Older People

老年人静脉血栓栓塞的决定因素

• 批准号: 7502144
• 负责人: Robert J Glynn
• 金额: $ 22.23万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-30 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7502144
• 关键词: Address; Age; Aging; Antioxidants; Archives; Aspirin; Attention; Autopsy; Biochemical Genetics; Blood specimen; Body Size; Body mass index; Cardiovascular Diseases; Case Study; Cell Adhesion Molecules; Cessation of life; Clinical; Condition; Country; Data; Deep Vein Thrombosis; Diabetes Mellitus; Diagnosis; Diet; Dietary Fiber; Dietary intake; Disease; End Point; Epidemiology; Event; Factor V Leiden mutation; Fatty acid glycerol esters; Fishes; Gene Mutation; Genetic Determinism; Genetic Polymorphism; Genetic Variation; Goals; Health; High Risk Woman; Homozygote; Incidence; Individual; Intake; Intercellular adhesion molecule 1; Jupiter; Life Style; Link; Literature; MTHFR gene; Malignant Neoplasms; Metabolic syndrome; Methods; Methylenetetrahydrofolate reductase (NADPH); Mutation; Myocardial Infarction; Operative Surgical Procedures; Outcome; P-Selectin; Participant; Persons; Pharmaceutical Preparations; Physicians; Play; Population; Population Study; Prevention strategy; Process; Proportional Hazards Models; Prospective Studies; Prothrombin; Pulmonary Embolism; Randomized; Rate; Records; Recurrence; Relative (related person); Reporting; Research Personnel; Risk; Risk Estimate; Risk Factors; Role; Specific qualifier value; Staging; Stroke; Structure; Thromboembolism; Thrombosis; Time; Trans Fats; Trauma; Variant; Venous; Venous Thrombosis; Vitamin B Complex; Vitamin E; Vitamins; Woman; Women' s Health; age related; base; behavior influence; cancer diagnosis; cancer risk; cancer site; cohort; design; end of life; factor V Leiden; follow-up; fruits and vegetables; genetic variant; hazard; male; men; modifiable risk; prevent; prospective; racial and ethnic; rosuvastatin

DESCRIPTION (provided by applicant): Venous thromboembolism (VTE), including both pulmonary embolism and deep vein thrombosis, is an age related condition with potentially catastrophic clinical consequences. Although VTE occurs as frequently as stroke in some populations, its epidemiology is not well understood. The broad goal of this application is to clarify the determinants of VTE, with a particular focus on those influenced by age, both to identify modifiable risk factors as well as those people who would benefit most from preventive strategies. Studies will utilize data from five populations: 39,876 women who participated in the Women's Health Study for over 10 years; 29,071 men who participated in the Physicians' Health Studies I and II, of whom 22,071 have over 20 years of follow-up since the initiation of the first trial; 8,171 women at high risk of cardiovascular disease who participated in the Women's Antioxidant Cardiovascular Disease Study for an average of 8 years, 508 people with prevalent, idiopathic VTE who participated in the PREVENT trial; and 17,802 people from 26 countries currently participating in the JUPITER trial of statins and cardiovascular disease. Parallel, centralized methods were used to review records and confirm reported cases of VTE. Archived blood samples are available for over 75% of participants. Main relationships to be evaluated include: whether intake of whole grains, fruit, and vegetables influence risk of VTE; the influence of comorbid conditions, especially cancer, cardiovascular disease, stroke and diabetes, on risk of VTE; interactions of genetic determinants of VTE, including factor V Leiden, the prothrombin mutation and polymorphisms in the MTHFR gene with age; whether genetic variants in adhesion molecules influence risk of VTE; and the impact of statins and the metabolic syndrome on risk of VTE. The combined populations will include over 1,500 incident cases of VTE. Studies will consider both a first occurrence of VTE as well as the risk of recurrent VTE. Methods of analysis include Kaplan-Meier estimates of cumulative risk and estimates of the relative hazard of VTE based on proportional hazards models. Strengths of the studies include their prospective design, high follow-up rates, detailed and reliable, long-term exposure and outcome information, and availability of blood samples on a high percentage of the population. Results will help identify high-risk older people, and potentially modifiable behaviors that influence risk of

描述（由申请人提供）：静脉血栓栓塞（VTE），包括肺栓塞和深静脉血栓形成，是与年龄相关的状况，具有潜在的灾难性临床后果。尽管VTE发生在某些人群中的频率与中风一样频繁，但其流行病学尚未得到很好的理解。该应用程序的广泛目标是阐明VTE的决定因素，特别关注受年龄影响的人，既可以识别可修改的危险因素以及那些将从预防策略中受益最大的人。研究将利用来自五个人群的数据：39,876名妇女参加了十多年的妇女健康研究； 29,071名参加了医生健康研究I和II的男性，自第一次试验开始以来，其中22,071人进行了20年的随访； 8,171名患有心血管疾病风险高的妇女参加了女性抗氧化性心血管疾病研究，平均为8年，有508人患有特发性VTE，参加了预防试验；来自26个国家的17,802人目前正在参加木星的汀类药物和心血管疾病试验。平行的集中方法用于审查记录并确认报告的VTE病例。超过75％的参与者可用于存档的血液样本。要评估的主要关系包括：全谷物，水果和蔬菜的摄入是否影响VTE的风险；合并症，尤其是癌症，心血管疾病，中风和糖尿病的影响对VTE的风险； VTE的遗传决定因素的相互作用，包括因子V Leiden，凝血酶原突变和MTHFR基因中的多态性；粘附分子中的遗传变异是否影响VTE的风险；他汀类药物和代谢综合征对VTE风险的影响。组合人口将包括1,500多个VTE事件案例。研究将考虑VTE的首次出现以及复发VTE的风险。分析方法包括基于比例危害模型的VTE的累积风险估计和VTE相对危害的估计。研究的优势包括它们的前瞻性设计，高后续率，详细且可靠的，长期的暴露和结果信息以及在大部分人群中的血液样本的可用性。结果将有助于识别高风险的老年人，并可能改变的行为，以影响