Individuals With Metabolic Syndrome Have Increased Risk Of Blood Clot Recurrence
Source: Thailand Medical News Jan 10, 2020 4 years, 10 months, 1 week, 5 days, 23 hours, 30 minutes ago
Individuals with
metabolic syndrome—a set of conditions including obesity, impaired glucose metabolism, elevated levels of fats and cholesterol in the blood, and high blood pressure, are more likely to experience recurrent
blood clots, according to a new study published today in
Blood Advances. Among patients diagnosed with a type of blood clot known as d
eep vein thrombosis (DVT), those who also had markers of metabolic syndrome were more likely to experience another
venous thromboembolism (
VTE) event.
Additionally, as the number of
metabolic syndrome conditions that the patients exhibited increased, so too did their likelihood of experiencing venous thromboembolism recurrence.
Currently, obesity continues to become more widespread worldwide; increasing along with obesity is the prevalence of
metabolic syndrome, which is now estimated to afflict about 34% of the U.S. population and 23% of the global population. While previous studies have suggested the syndrome can be tied to higher risk of an initial
venous thromboembolism event, this is the largest study of
DVT patients to date to show that
metabolic syndrome plays an important role in
VTE recurrence.
Medical researchers used a statewide database, the Indiana Network for Patient Care, to analyze 151,054 patients diagnosed with
DVT between 2004-2017. They examined four
metabolic syndrome components—hypertension (high blood pressure), hyperlipidemia (high levels of fat in the blood), diabetes (high levels of sugar in the blood), and obesity and found that 68% of
DVT patients had also been diagnosed with at least one of those conditions. The presence of comorbid
metabolic syndrome was associated with a 17% increase in overall likelihood of
blood clot recurrence.
The research also showed that the risk of subsequent
blood clots increased with each additional
metabolic syndrome component: patients without any of the four markers for
metabolic syndrome had a
VTE recurrence rate of 7%. Those patients who had been diagnosed with one component of metabolic syndrome were found to be at a 14% risk of additional
blood clots, followed by 21% risk among patients with two components, 30% for those with three components, and 37% for those diagnosed with all four components.
The study's first author Dr Lauren K. Stewart, MD, of the Indiana University School of Medicine's Department of Emergency Medicine told
Thailand Medical News, "Our aim was to improve understanding of the effect of
metabolic syndrome on
blood clot recurrence.
If patients have
VTE recurrence, their quality of life drops, and it drops a lot. We wanted to investigate possible comorbidities and factors that affect recurrence so we could stimulate research into new potential treatments."
Venous thromboembolism or
VTE poses a significant burden not only to public health—it is estimated that around 900,000 people could be affected by
VTE in the United States each year—but also to individual quality of life. Patients who have been diagnosed with
DVT may experience chronic, debilitating pain; edema and swelling; and skin ulcerations.
The medical researchers suggest that addressing comorbid
metabolic syndrome conditions among
DVT patients may alleviate or prevent some of the harmful effects of
VTE recurrence. "This study underscores the need for further research into co-treating
metabolic syndrome in addition to prescribing anticoagulants," said Dr. Stewart. "Physicians may now want to consider checking other boxes—is the patient's hypertension being addressed? Is the hyperlipidemia, the glucose intolerance? Have I talked to the patient about exercise and diet?"
Another significant finding involved the role of anticoagulant therapy: the researchers found that although patients who had been diagnosed with both
DVT and
metabolic syndrome had higher documented rates and duration of anticoagulant use, the link between
metabolic syndrome and increased risk of
venous thromboembolism recurrence persisted. This suggests that
metabolic syndrome may have an even greater effect on
venous thromboembolism risk than observed, and that the effect may have been minimized due to anticoagulant therapy.
The researchers hope their findings will empower patients and physicians to work together to address the tie between
venous thromboembolism or VTE and
metabolic syndrome. "Having one or more of these conditions of obesity, hyperlipidemia, hypertension, or diabetes creates a worse outcome for patients with
blood clots. But the good news is, all four of these conditions can be treated and modified," said Dr. Stewart.
Reference : Metabolic syndrome increases risk of venous thromboembolism recurrence after acute deep vein thrombosis,Lauren K. Stewart, Jeffrey A. Kline et al https://doi.org/10.1182/bloodadvances.2019000561
