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Risk Stratification

Mili FD, Hooper WC, Lally C et al.  Thromb Res 2011;127:309–16.

This case–control study was performed to evaluate the contribution of family history to the risk of venous thrombosis among blacks compared with whites, in relation to environmental risk factors such as obesity, diabetes mellitus, hypertension, and cancer. The results of this study show that the adjusted attributable fraction for venous thromboembolism was comparable between blacks and whites (16.9% vs. 18.3%). Moreover, diabetes, cancer, and obesity among blacks or among females of both races further increased the risk of venous thromboembolism by at least two- to three-fold.

 

Family history is a well known risk indicator for a first venous thrombosis [1]. As well as a positive family history, it has been shown that additional genetic or environmental thrombotic risk factors further increase the risk of venous thromboembolism. However, the majority of patients in these studies were white. The authors of the present work aimed to study the associations in a large population of black patients. A total of 1094 patients (537 black patients) with a deep vein thrombosis or pulmonary embolism and 1264 control patients (586 black patients) were interviewed about their family history and comorbid conditions. Overall, the impact of a positive family history was comparable between white and black patients. Using conditional logistic regression models, the authors found several specific clusters of risk factors that showed particularly increased risk for the following family members:

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