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Myocardial infarction, prothrombotic genotypes, and venous thrombosis risk: The Tromsø Study

Joakim K Sejrup1, Vania M Morelli1, Maja-Lisa Løchen2

  • 1K.G. Jebsen-Thrombosis Research and Expertise Center (TREC) Department of Clinical Medicine UiT The Arctic University of Norway Tromsø Norway.

Research and Practice in Thrombosis and Haemostasis
|February 29, 2020
PubMed

Insights

Myocardial infarction (MI) increases venous thromboembolism (VTE) risk. Prothrombotic genotypes do not further elevate VTE risk in MI patients, suggesting other factors are involved.

Area of Science:

  • Cardiovascular Genetics
  • Thrombosis and Hemostasis

Background:

  • Myocardial infarction (MI) is a known risk factor for venous thromboembolism (VTE).
  • Prothrombotic genotypes, implicated in VTE, are also linked to MI risk.
  • The combined impact of MI and prothrombotic single-nucleotide polymorphisms (SNPs) on VTE risk remains under-investigated.

Purpose of the Study:

  • To investigate the synergistic effect of myocardial infarction (MI) and prothrombotic single-nucleotide polymorphisms (SNPs) on the risk of venous thromboembolism (VTE).
  • To determine if specific genetic variations modify VTE risk in patients with a history of MI.

Main Methods:

  • A case-control study design was employed, identifying 641 incident venous thromboembolism (VTE) cases and 1761 controls from the Tromsø Study (1994-2012).
  • DNA genotyping was performed for five key prothrombotic single-nucleotide polymorphisms (SNPs): rs8176719 (ABO), rs6025 (F5), rs1799963 (F2), rs2066865 (FGG), and rs2036914 (F11).
  • Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated to assess VTE risk based on MI status and the presence of risk alleles for the selected SNPs.

Main Results:

  • Patients with myocardial infarction (MI) exhibited a 1.4-fold increased risk of venous thromboembolism (VTE); this association remained significant after adjusting for the five studied single-nucleotide polymorphisms (SNPs) (adjusted HR, 1.52; 95% CI, 1.12-2.07).
  • In individuals without MI, each prothrombotic SNP was associated with an increased VTE risk, with a cumulative increase observed with a higher number of risk alleles in the 5-SNP score.
  • Crucially, the combination of MI and prothrombotic genotypes, whether individual SNPs or the combined 5-SNP score, did not lead to an additional or synergistic increase in VTE risk.

Conclusions:

  • The elevated risk of venous thromboembolism (VTE) following myocardial infarction (MI) is not attributable to the five investigated prothrombotic genotypes.
  • Prothrombotic genetic variations do not confer an additional risk of VTE in patients who have experienced a myocardial infarction.
Abstract

Keywords:
epidemiologygeneticsmyocardial infarctionpulmonary embolismrisk factorsthromboembolismvenous

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