Is Venous Thromboembolism a Chronic Inflammatory Disease?
Key result
In individuals without overt autoimmune disease, a rheumatoid factor concentration ≥100 IU/mL was strongly associated with an increased risk of DVT over up to 32 years of follow-up (HR 3.1).
Why the study?
Does increased rheumatoid factor concentration increase the risk of incident DVT in individuals without overt autoimmune disease?
Structured PICO
Does increased rheumatoid factor concentration increase the risk of incident DVT in individuals without overt autoimmune disease?
P
Population
>54,000 participants without overt autoimmune disease from two Danish cohorts followed for up to 32 years to evaluate the association between rheumatoid factor and VTE.
E
Exposure
Rheumatoid factor concentration ≥100 IU/mL
C
Comparator
Rheumatoid factor concentration ≤100 IU/mL
O
Outcome
Incident deep vein thrombosis (DVT)hard clinical
Main Result
Hazard Ratio: 3.1
Limitations
- Homogeneous composition of the study population may limit generalizability to other populations of varying ethnicity and race.
- Selecting a low cutpoint (≥15 IU/mL) resulted in a higher than expected prevalence of rheumatoid factor seropositivity (nearly 17%).
- The observation that increased rheumatoid factor concentration was predictive of incident DVT but not PE requires external validation.
- Homogeneous composition of the study population limiting generalizability to other ethnicities and races
- Use of lowest cutpoint value (≥15 IU/mL) resulting in unusually high 17% seropositivity
- Observation that increased rheumatoid factor predicted DVT but not PE requires external validation
Authors
Discussion
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Implication
Increased concentrations of rheumatoid factor are strongly associated with an increased risk of incident DVT in individuals without overt autoimmune disease, supporting the hypothesis that venous thromboembolism is a chronic inflammatory disease.
Cite This Study
Piazza et al. (2014) conducted an editorial in Venous thromboembolism (VTE) (n=54,000). Rheumatoid factor concentration ≥100 IU/mL vs. Rheumatoid factor concentration ≤100 IU/mL was evaluated on Deep vein thrombosis (DVT) (HR 3.1). In individuals without overt autoimmune disease, a rheumatoid factor concentration ≥100 IU/mL was strongly associated with an increased risk of DVT over up to 32 years of follow-up (HR 3.1).