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Semin Thromb Hemost 2016; 42(08): 808-820
DOI: 10.1055/s-0036-1592333
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Environmental and Genetic Risk Factors Associated with Venous Thromboembolism

Marta Crous-Bou   *
1   Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
2   Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
,
Laura B. Harrington   *
3   Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
,
Christopher Kabrhel
4   Department of Emergency Medicine, Center for Vascular Emergencies, Massachusetts General Hospital, Boston, Massachusetts
› Author Affiliations
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Publication History

Publication Date:
20 October 2016 (online)

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Abstract

Venous thromboembolism (VTE) includes deep vein thrombosis and pulmonary embolism, and a combination of environmental and genetic risk factors contributes to VTE risk. Within environmental risk factors, some are provoking (e.g., cancer, surgery, trauma or fracture, immobilization, pregnancy and the postpartum period, long-distance travel, hospitalization, catheterization, and acute infection) and others are nonprovoking (e.g., age, sex, race/ethnicity, body mass index and obesity, oral contraceptive or hormone therapy use, corticosteroid use, statin use, diet, physical activity, sedentary time, and air pollution). Additionally, VTE has a strong genetic basis, with approximately 50 to 60% of the variance in VTE incidence attributed to genetic effects. Some genetic susceptibility variants that contribute to risk have been identified in candidate genes, mostly related to the clotting system and responsible for inherited hypercoagulable states (e.g., factor V Leiden, prothrombin, fibrinogen gamma, or blood group non-O). Other susceptibility single-nucleotide polymorphisms have been identified from genome-wide association studies, such as the two new loci in TSPAN15 (rs78707713) and SCL44A2 (rs2288904) genes. Risk factors are not always associated with VTE in isolation; however, and an understanding of how environmental and genetic factors interact may provide insight into the pathophysiology of VTE, possibly identifying opportunities for targeted prevention and treatment.

Keywords

venous thromboembolism - epidemiology - genetics - risk factors

* The authors Marta Crous-Bou and Laura B. Harrington contributed equally to the article.


 

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