Serum albumin and risk of venous thromboembolism

Aaron R. Folsom; Pamela L. Lutsey; Susan R. Heckbert; Mary Cushman

doi:10.1160/TH09-12-0856

Thrombosis and Haemostasis, Inhaltsverzeichnis

Thromb Haemost 2010; 104(01): 100-104
DOI: 10.1160/TH09-12-0856

Blood Coagulation, Fibrinolysis and Cellular Haemostasis

Schattauer GmbH

Serum albumin and risk of venous thromboembolism

Aaron R. Folsom

¹Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA

,

Pamela L. Lutsey

¹Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA

,

Susan R. Heckbert

²Department of Epidemiology, Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, USA

,

Mary Cushman

³Department of Medicine, University of Vermont, Burlington, Vermont, USA, and Department of Pathology, University of Vermont, Burlington, Vermont, USA

› Institutsangaben

Abstract

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Summary

The incidence of venous thromboembolism (VTE) is increased in patients with albuminuria. However, whether a low serum albumin concentration is associated with increased risk of VTE has been a matter of controversy. We determined the association of serum albumin with VTE incidence in two large, prospective, population-based cohorts: the Atherosclerosis Risk in Communities (ARIC) Study (n = 15,300) and the Cardiovascular Health Study (CHS) (n = 5,400). Validated VTE occurrence (n = 462 in ARIC and n = 174 in CHS) was ascertained during follow-up. In both studies, after adjustment for age, sex, race, use of hormone replacement therapy, estimated glomerular filtration rate, history of cancer, and diabetes, serum albumin tended to be associated inversely with VTE. The adjusted hazard ratio per standard deviation lower albumin was 1.18 (95% confidence interval [CI] = 1.08, 1.31) in ARIC and 1.10 (95% CI = 0.94, 1.29) in CHS. The hazard ratio for albumin below (vs. above) the fifth percentile was 1.28 (95% CI = 0.90, 1.84) in ARIC and 1.80 (95% CI = 1.11, 2.93) in CHS. In conclusion, low serum albumin was a modest marker of increased VTE risk. The observed association likely does not reflect cause and effect, but rather that low serum albumin reflects a hyperinflammatory or hypercoagulable state. Whether this association has clinical relevance warrants further study.

Keywords

Albumin - prospective study - pulmonary embolism - venous thrombosis

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Referenzen

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