Alcohol consumption is associated with a decreased risk of venous thrombosis

Elisabeth R Pomp; Frits R Rosendaal; Carine J. M Doggen

doi:10.1160/TH07-07-0470

Thrombosis and Haemostasis, Inhaltsverzeichnis

Thromb Haemost 2008; 99(01): 59-63
DOI: 10.1160/TH07-07-0470

Blood Coagulation, Fibrinolysis and Cellular Haemostasis

Schattauer GmbH

Alcohol consumption is associated with a decreased risk of venous thrombosis

Elisabeth R Pomp

¹Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands

,

Frits R Rosendaal

¹Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands

²Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands

³Thrombosis and Haemostasis Research Center, Leiden University Medical Center, Leiden, The Netherlands

,

Carine J. M Doggen

¹Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands

› Institutsangaben

Abstract

Summary

Moderate alcohol consumption is associated with lower levels of several coagulation factors. It is an established protective factor for cardiovascular disease; however, the effect on venous thrombosis is unknown. In a large population-based case-control study, we evaluated the association between alcohol consumption and the risk of venous thrombosis. The MEGA study included consecutive patients with a first venous thrombosis between March 1999 and September 2004 from six anticoagulation clinics in the Netherlands. Partners of patients were asked to participate, and additional controls were recruited using a random digit dialling method. All participants completed a standardized questionnaire, and blood samples were collected. A total of 4,423 patients and 5,235 controls were included in the analyses. Alcohol consumption was associated with a reduced risk of venous thrombosis, with 2–4 glasses per day resulting in the largest beneficial effect (odds ratio [OR] 0.67, 95% confidence interval [CI95] 0.58–0.77) compared to abstainers. The effect was more pronounced in women (OR 0.66, CI95 0.53–0.84) than men (OR 0.82, CI95 0.63–1.07) and also more striking for pulmonary embolism (OR 0.56, CI95 0.46–0.70) than for deep venous thrombosis of the leg (OR 0.74, CI95 0.63–0.88). Compared to abstainers, fibrinogen levels were decreased in individuals who consumed alcohol (maximum decrease: 0.30 g/l). FactorVII and vonWillebrand levels were mildly decreased in these individuals but not consistently over the categories of alcohol consumption. In conclusion, alcohol consumption is associated with a reduced risk of venous thrombosis, which may be in part mediated by decreased fibrinogen levels. Thromb

Keywords

Alcohol - case-control study - epidemiology - risk factors - venous thrombosis

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Referenzen

References
1 Booyse FM, Parks DA. Moderate wine and alcohol consumption: beneficial effects on cardiovascular disease. Thromb Haemost 2001; 86: 517-528.
2 Lee KW, Lip GYH. Effects of lifestyle on hemostasis, fibrinolysis, and platelet reactivity: a systematic review. Arch Intern Med 2003; 163: 2368-2392.
3 Pahor M, Guralnik JM, Havlik RJ. et al. Alcohol consumption and risk of deep venous thrombosis and pulmonary embolism in older persons. J Am Geriatr Soc 1996; 44: 1030-1037.
4 Tsai AW, Cushman M, Rosamond WD. et al. Cardiovascular risk factors and venous thromboembolism incidence: the longitudinal investigation of thromboembolism etiology. Arch Intern Med 2002; 162: 1182-1189.
5 Glynn RJ, Rosner B. Comparison of risk factors for the competing risks of coronary heart disease, stroke, and venous thromboembolism. Am J Epidemiol 2005; 162: 975-982.
6 Samama MM. An epidemiologic study of risk factors for deep vein thrombosis in medical outpatients: the Sirius study. Arch Intern Med 2000; 160: 3415-3420.
7 World Health Organisation. WHO Global Status Report on alcohol, 2004. Available at: http://www.who.int/substance_abuse/publications/global_status_report_2004_overview.pdf. Accessed July 23, 2007.
8 Blom JW, Doggen CJM, Osanto S. et al. Malignancies, prothrombotic mutations, and the risk of venous thrombosis. J Am Med Assoc 2005; 293: 715-722.
9 Clauss A. Rapid physiological coagulation method in determination of fibrinogen. Acta Haematol 1957; 17: 237-246.
10 Cannegieter SC, Doggen CJM, van Houwelingen HC. et al. Travel-related venous thrombosis: Results from a large population-based case control study (MEGA Study). PLoS Med 2006; 3: 1258-1265.
11 Pomp ER, le Cessie S, Rosendaal FR. et al. Risk of venous thrombosis: obesity and its joint effect with oral contraceptive use and prothrombotic mutations. Br J Haematol 2007; 139: 289-296.
12 Yarnell JWG, Sweetnam PM, Rumley A. et al. Lifestyle factors and coagulation activation markers: the Caerphilly Study. Blood Coagul Fibrinolysis 2001; 12: 721-728.
13 Mukamal KJ, Jadhav PP, D'Agostino RB. et al. Alcohol consumption and hemostatic factors: analysis of the Framingham Offspring cohort. Circulation 2001; 104: 1367-1373.
14 Wannamethee SG, Lowe GDO, Shaper G. et al. The effects of different alcoholic drinks on lipids, insulin and haemostatic and inflammatory markers in older men. Thromb Haemost 2003; 90: 1080-1087.
15 Schröder H, Masabeu A, Marti MJ. et al. Myocardial infarction and alcohol consumption: a population- based case-control study. Nutr Metab Cardiovasc Dis 2007; 17: 609-615.