Several hemostatic factors and inflammatory markers are associated with the risk of incident venous thromboembolism (VTE), however most existing data are from case-control studies in Caucasian populations.
We aimed to prospectively confirm previous findings, and explore less studied biomarkers in relation to VTE risk in a multi-racial/ethnic cohort.
Circulating levels of factor VIII, fibrinogen, D-dimer, plasmin-antiplasmin complex (PAP), C-reactive protein (CRP) and interleukin-6 (IL-6) were measured at baseline (2000-02) in 6,706 participants of the Multi-Ethnic Study of Atherosclerosis (MESA). Incident VTE was identified using hospitalization discharge codes from baseline to December 31, 2015. Hazard ratios (HRs) of VTE were estimated in Cox regression models.
There were 227 events during a median of 14 years of follow-up. Compared with participants in the lowest quartile, the HRs for those above the 95 percentile and p for trend across categories were 3.50 (95% CI 1.98-6.19; p<0.001) for D-dimer, 1.49 (95% CI 0.84-2.63; p=0.02) for factor VIII, 1.32 (95% CI 0.76-2.28; p=0.99) for fibrinogen, 1.92 (95%CI 1.08-3.42; p=0.15) for PAP, 1.68 (95% CI 0.81-3.48; p=0.08) for CRP and 2.55 (95% CI 1.15-5.66; p=0.07) for IL-6, after adjustment for demographics and body mass index. For CRP and IL-6, follow-up was restricted to ten years due to violations of the proportional hazards assumption. No significant interactions by age/ethnicity were observed.
We demonstrated a fairly novel association between PAP and risk of incident VTE, and contributed further prospective confirmation regarding the associations of D-dimer, factor VIII, and IL-6 with VTE.

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