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Platelet function as a risk factor for venous thromboembolism in the Framingham Heart Study
Marja K Puurunen1, Shih-Jen Hwang2, Chris J O'Donnell3
1Framingham Heart Study of Boston University School of Medicine and NHLBI, Framingham, MA, USA.
Thrombosis Research
|February 3, 2017
Summary
Platelet function is weakly linked to venous thromboembolism (VTE) risk. While higher collagen lag time showed a trend toward increased VTE, increased epinephrine aggregation suggested lower risk in this community study.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Thrombosis Research
Background:
- The link between platelet reactivity and venous thromboembolism (VTE) remains unclear.
- Platelet function is crucial in arterial thrombosis, and antiplatelet agents may influence VTE development.
- This study investigates baseline platelet function's role in VTE incidence within the Framingham Heart Study cohort.
Purpose of the Study:
- To determine the association between baseline platelet aggregability and the risk of developing venous thromboembolism (VTE).
- To explore the role of specific platelet function markers (collagen, ADP, epinephrine) in VTE development in a community-based cohort.
Main Methods:
- Utilized light transmission aggregometry to measure platelet aggregation in response to collagen, ADP, and epinephrine.
- Analyzed data from 2831 participants in the Framingham Offspring and Omni cohorts.
- Assessed VTE events over a median follow-up of 20.4 years.
Main Results:
- An increased collagen lag time was associated with a higher risk of incident VTE (HR 1.01 [1.00-1.02]; p=0.049) in adjusted analyses.
- Increased maximal aggregation to low-dose epinephrine (1.0µM) was linked to a lower VTE risk (HR 0.84 [0.71-0.99]; p=0.042).
- Multivariable analyses, particularly adjusting for BMI, attenuated these associations to trends, suggesting a weak and paradoxical relationship.
Conclusions:
- Baseline platelet aggregability shows only a weak association with incident VTE in this community-based population.
- The observed associations were paradoxical and attenuated by factors like BMI.
- Further research may benefit from exploring other markers of platelet function and hemostasis for predicting VTE risk.