PMID- 33763945
OWN - NLM
STAT- MEDLINE
DCOM- 20210708
LR  - 20230829
IS  - 1538-7836 (Electronic)
IS  - 1538-7836 (Linking)
VI  - 19
IP  - 6
DP  - 2021 Jun
TI  - Severe alpha-1-antitrypsin deficiency increases the risk of venous 
      thromboembolism.
PG  - 1519-1525
LID - 10.1111/jth.15302 [doi]
AB  - BACKGROUND: Severe alpha-1-antitrypsin deficiency (AATD), phenotype PiZZ, is 
      associated with increased risk of liver disease and chronic obstructive pulmonary 
      disease (COPD), but the risk of venous thromboembolism (VTE) is unknown. Our aim 
      was to evaluate the risk of VTE in individuals with severe AATD compared with 
      control subjects from the general population. METHODS: Individuals with severe 
      AATD (n = 1577) were recruited from the Swedish national AATD register. Control 
      subjects (n = 5969) were selected from the OLIN (Obstructive Lung Disease in 
      Northern Sweden) studies, that include a random general population sample. 
      Longitudinal data on VTE and diagnoses were obtained from the Swedish National 
      Patient Registry. Associations were analyzed using multivariable Cox regression. 
      RESULTS: At inclusion, 46% of the AATD individuals and 53% of the controls were 
      never-smokers. COPD was present in 46% of the AATD individuals compared with 4% 
      of the controls. During a median follow-up of 18 years, 116 (7%) of the AATD 
      individuals and 89 (1%) of the control subjects developed VTE, unadjusted hazard 
      ratio 6.5 (95% confidence interval 4.9-8.6). Risk factors for incident VTE were 
      male gender, age, COPD, cancer, and liver disease. Adjusting for these factors, 
      the AATD individuals had a significantly higher risk of incident VTE, adjusted 
      hazard ratio 4.2 (95% confidence interval 2.9-6.2) as compared with the controls. 
      CONCLUSION: Subjects with severe AATD have considerably increased risk of 
      developing VTE compared with the general population, even after accounting for 
      risk factors. This calls for optimized risk factor management and clinical 
      follow-up of this patient group.
CI  - (c) 2021 The Authors. Journal of Thrombosis and Haemostasis published by Wiley 
      Periodicals LLC on behalf of International Society on Thrombosis and Haemostasis.
FAU - Basil, Nawfal
AU  - Basil N
AD  - Department of Respiratory Medicine, Skane University Hospital, Lund University, 
      Malmo, Sweden.
FAU - Ekstrom, Magnus
AU  - Ekstrom M
AD  - Department of Clinical Sciences Lund, Respiratory Medicine and Allergology, 
      Faculty of Medicine, Lund University, Lund, Sweden.
FAU - Piitulainen, Eeva
AU  - Piitulainen E
AD  - Department of Respiratory Medicine, Skane University Hospital, Lund University, 
      Malmo, Sweden.
FAU - Lindberg, Anne
AU  - Lindberg A
AD  - Division of Medicine, Department of Public Health and Clinical Medicine, Umea 
      University, Umea, Sweden.
FAU - Ronmark, Eva
AU  - Ronmark E
AD  - The OLIN Unit, Division of Occupational and Environmental Medicine, Department of 
      Public Health and Clinical Medicine, Umea University, Umea, Sweden.
FAU - Jehpsson, Lars
AU  - Jehpsson L
AD  - Department of Clinical Sciences, Skane University Hospital, Lund University, 
      Lund, Sweden.
FAU - Tanash, Hanan
AU  - Tanash H
AD  - Department of Respiratory Medicine, Skane University Hospital, Lund University, 
      Malmo, Sweden.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20210409
PL  - England
TA  - J Thromb Haemost
JT  - Journal of thrombosis and haemostasis : JTH
JID - 101170508
SB  - IM
MH  - Humans
MH  - Male
MH  - *Pulmonary Disease, Chronic Obstructive/complications/diagnosis/epidemiology
MH  - Risk Factors
MH  - Sweden/epidemiology
MH  - *Venous Thromboembolism/diagnosis/epidemiology
MH  - *alpha 1-Antitrypsin Deficiency/complications/diagnosis/epidemiology
OTO - NOTNLM
OT  - COPD
OT  - alpha-1-antitrypsin deficiency
OT  - deep vein thrombosis
OT  - pulmonary embolism
OT  - venous thromboembolism
EDAT- 2021/03/26 06:00
MHDA- 2021/07/09 06:00
CRDT- 2021/03/25 06:52
PHST- 2021/02/23 00:00 [revised]
PHST- 2020/12/15 00:00 [received]
PHST- 2021/03/03 00:00 [accepted]
PHST- 2021/03/26 06:00 [pubmed]
PHST- 2021/07/09 06:00 [medline]
PHST- 2021/03/25 06:52 [entrez]
AID - S1538-7836(22)00785-1 [pii]
AID - 10.1111/jth.15302 [doi]
PST - ppublish
SO  - J Thromb Haemost. 2021 Jun;19(6):1519-1525. doi: 10.1111/jth.15302. Epub 2021 Apr 
      9.