Blood coagulation factors and risk of venous thromboembolism: a population-based study

The prevalence of venous thromboembolism (VTE) and the impact of blood coagulation factors on the occurrence of VTE in the general population have been rarely studied.

In the KORA-Fit (S4) study with n = 805 participants (53% females) with a mean age of 62.4 (SD 5.7) years, the prevalence of physician-diagnosed VTE was assessed during a face-to-face interview. Plasma concentrations of antithrombin, fibrinogen, factor VIII, D-dimer, protein C, and protein S activity were analyzed; additionally, aPTT and prothrombin time were assessed as screening tests. The associations between coagulation factors and VTE were analyzed using multivariable logistic regression models. Non-linear associations were explored using restricted cubic splines.

The self-reported prevalence of VTE was 3.2%. The blood coagulation factors examined did not differ between individuals with and without VTE, except for factor VIII. In multivariable analyses, protein C (adjusted p = 0.008), protein S (adjusted p = 0.008), and aPTT (adjusted p = 0.016) were non-linearly inversely associated with VTE.

Our findings in a middle-aged and elderly population demonstrate significant associations between specific blood coagulation factors and the prevalence of VTE. However, these hypothesis-generating findings must be confirmed in prospective cohort studies. Also, research on the complex interactions between coagulation factors and patient-specific risk factors in the pathogenesis of VTE is warranted.