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'''Editors-in-Chief:''' [[C. Michael Gibson, M.S., M.D.]] '''Associate Editor-In-Chief''': [[User:Ujjwal Rastogi|Ujjwal Rastogi, MBBS]] [mailto:urastogi@perfuse.org]
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| [[Deep vein thrombosis resident survival guide|'''Resident'''<br>'''Survival'''<br>'''Guide''']]
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'''Editor(s)-In-Chief:''' {{ATI}}, [[C. Michael Gibson, M.S., M.D.]] [mailto:charlesmichaelgibson@gmail.com]; '''Associate Editor(s)-In-Chief:''' {{CZ}}  [[User:Kashish Goel|Kashish Goel, M.D.]]; '''Assistant Editor(s)-In-Chief:''' [[User:Justine Cadet|Justine Cadet]]; {{Rim}}
{{Deep vein thrombosis}}
{{Deep vein thrombosis}}


==Overview==
==Overview==
The presence of a risk factor plays a major role in the management of DVT. An understanding of the risk factors for venous thrombosis is necessary in order to maximize the prevention of this disease in high risk individuals and groups of patientsFurthermore,
Venous thromboembolism (VTE) consists of [[deep vein thrombosis]] (DVT), [[pulmonary embolism]] (PE), or both.  In these chapters on VTE, the word risk factors refers to those epidemiologic and genetic variables that expose someone to a higher risk of developing [[venous thrombosis]].  The word triggers refer to those factors in the patients immediate history or environment that may have led to the occurrence of the [[venous thrombosis]]. The risk factors for VTE are a constellation of predisposing conditions which stem from the three principles of [[Virchow's triad]]: stasis of the blood flow, damage to the vascular [[endothelial cell]]s, and [[hypercoagulability]].  The risk factors for VTE can be classified as temporary, modifiable and non-modifiable.  It is suggested that [[venous thrombosis]] also shares risk factors with [[arterial thrombosis]], such as [[obesity]], [[hypertension]], [[smoking]], and [[diabetes mellitus]].<ref name="pmid20620709">{{cite journal| author=Goldhaber SZ| title=Risk factors for venous thromboembolism. | journal=J Am Coll Cardiol | year= 2010 | volume= 56 | issue= 1 | pages= 1-7 | pmid=20620709 | doi=10.1016/j.jacc.2010.01.057 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20620709  }} </ref>
*Short-term anticoagulation is required for transient risk factors.
 
*Long-term anticoagulation is given in following conditions
==Risk Factors==
# Thrombosis due to an unknown cause.
 
# In chronic diseases like [[coronary artery disease]]
Shown below is a list of predisposing factors to [[VTE]].<ref name="pmid12814980">{{cite journal| author=Anderson FA, Spencer FA| title=Risk factors for venous thromboembolism. | journal=Circulation | year= 2003 | volume= 107 | issue= 23 Suppl 1 | pages= I9-16 | pmid=12814980 | doi=10.1161/01.CIR.0000078469.07362.E6 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12814980  }} </ref><ref name="pmid18757870">{{cite journal| author=Torbicki A, Perrier A, Konstantinides S, Agnelli G, Galiè N, Pruszczyk P et al.| title=Guidelines on the diagnosis and management of acute pulmonary embolism: the Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). | journal=Eur Heart J | year= 2008 | volume= 29 | issue= 18 | pages= 2276-315 | pmid=18757870 | doi=10.1093/eurheartj/ehn310 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18757870 }} </ref> The risk factors are classified as moderate or weak depending on how strongly they predispose for a VTE.
# Presence of persistent risk factors.
 
{| style="cellpadding=0; cellspacing= 0; width: 600px;"
|-
| style="padding: 0 5px; font-size: 100%; background: #F5F5F5;" align=center |'''Moderate risk factors''' || style="padding: 0 5px; font-size: 100%; background: #F5F5F5;" align=center |'''Weak risk factors'''
|-
|  style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left |
❑ [[Chemotherapy]]<br>
❑ [[Chronic heart failure]]<br>
❑ [[Respiratory failure]]<br>
❑ [[Hormone replacement therapy]]<br>
❑ [[Cancer]]<br>
❑ [[Oral contraceptive pills]] <br>
❑ [[Stroke]] <br>
❑ [[Pregnancy]] <br>
❑ [[Postpartum]] <br>
❑ Prior history of [[VTE]] <br>
❑ [[Thrombophilia]] <br>
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left |❑ Advanced [[age]] <br>
❑ [[Laparoscopic surgery]] <br>
❑ Prepartum <br>
❑ [[Obesity]] <br>
[[Varicose veins]]
|}
 
 
The risk factors of VTE can be further classified into modifiable, non-modifiable and temporary.


Risk factors for DVT can be sub-divided in various sections like
===Modifiable Risk Factors===
# Modifiable
Modifiable risk factors are reversible based upon lifestyle/behavior modification.
# Non-Modifiable
* [[Obesity]]: [[Obesity]] is defined as a [[body-mass index]] (BMI) above 30 kg/m2.<ref name="pmid20404252">{{cite journal| author=Holst AG, Jensen G, Prescott E| title=Risk factors for venous thromboembolism: results from the Copenhagen City Heart Study. | journal=Circulation | year= 2010 | volume= 121 | issue= 17 | pages= 1896-903 | pmid=20404252 | doi=10.1161/CIRCULATIONAHA.109.921460 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20404252  }} </ref> <ref name="pmid21352080">{{cite journal| author=Vayá A, Martínez-Triguero ML, España F, Todolí JA, Bonet E, Corella D| title=The metabolic syndrome and its individual components: its association with venous thromboembolism in a Mediterranean population. | journal=Metab Syndr Relat Disord | year= 2011 | volume= 9 | issue= 3 | pages= 197-201 | pmid=21352080 | doi=10.1089/met.2010.0117 | pmc= | url= }} </ref> <ref name="pmid18695082">{{cite journal| author=Eichinger S, Hron G, Bialonczyk C, Hirschl M, Minar E, Wagner O et al.| title=Overweight, obesity, and the risk of recurrent venous thromboembolism. | journal=Arch Intern Med | year= 2008 | volume= 168 | issue= 15 | pages= 1678-83 | pmid=18695082 | doi=10.1001/archinte.168.15.1678 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18695082  }} </ref>
# Temporary
# Potential New Risk Factors.


==Modifiable risk factors==
* [[Smoking]]:<ref name="pmid20404252">{{cite journal| author=Holst AG, Jensen G, Prescott E| title=Risk factors for venous thromboembolism: results from the Copenhagen City Heart Study. | journal=Circulation | year= 2010 | volume= 121 | issue= 17 | pages= 1896-903 | pmid=20404252 | doi=10.1161/CIRCULATIONAHA.109.921460 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20404252  }} </ref> [[Smoking]] significantly increases the risk of [[DVT]], particularly among women who are taking [[oral contraceptive pills]] as well as among [[obese]] people.
'''Obesity:'''  Obesity is defined as a body-mass index (BMI) above 30 kg/m2. Underweight subjects have reduced risk while obese people have significant risk for DVT, and or PE.<ref name="pmid20404252">{{cite journal| author=Holst AG, Jensen G, Prescott E| title=Risk factors for venous thromboembolism: results from the Copenhagen City Heart Study. | journal=Circulation | year= 2010 | volume= 121 | issue= 17 | pages= 1896-903 | pmid=20404252 | doi=10.1161/CIRCULATIONAHA.109.921460 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20404252  }} </ref> <ref name="pmid21352080">{{cite journal| author=Vayá A, Martínez-Triguero ML, España F, Todolí JA, Bonet E, Corella D| title=The metabolic syndrome and its individual components: its association with venous thromboembolism in a Mediterranean population. | journal=Metab Syndr Relat Disord | year= 2011 | volume= 9 | issue= 3 | pages= 197-201 | pmid=21352080 | doi=10.1089/met.2010.0117 | pmc= | url= }} </ref> <ref name="pmid18695082">{{cite journal| author=Eichinger S, Hron G, Bialonczyk C, Hirschl M, Minar E, Wagner O et al.| title=Overweight, obesity, and the risk of recurrent venous thromboembolism. | journal=Arch Intern Med | year= 2008 | volume= 168 | issue= 15 | pages= 1678-83 | pmid=18695082 | doi=10.1001/archinte.168.15.1678 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18695082  }} </ref>


In a number of high-risk settings such as Smoking <ref name="pmid20404252">{{cite journal| author=Holst AG, Jensen G, Prescott E| title=Risk factors for venous thromboembolism: results from the Copenhagen City Heart Study. | journal=Circulation | year= 2010 | volume= 121 | issue= 17 | pages= 1896-903 | pmid=20404252 | doi=10.1161/CIRCULATIONAHA.109.921460 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20404252 }} </ref>, Use of hormonal contraceptive, and long flights, Obesity appears to be a contributing factor for further increasing the risk of VTE
* Use of [[oral contraceptives]]<ref name="pmid17726684">{{cite journal| author=Pomp ER, Rosendaal FR, Doggen CJ| title=Smoking increases the risk of venous thrombosis and acts synergistically with oral contraceptive use. | journal=Am J Hematol | year= 2008 | volume= 83 | issue= 2 | pages= 97-102 | pmid=17726684 | doi=10.1002/ajh.21059 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17726684 }} </ref>


'''Homocysteine''' Elevated homocysteine has been consistently reported as a risk factor for venous thrombosis and levels can be reduced with B vitamin supplementation <ref name="pmid17024599">{{cite journal| author=Cattaneo M| title=Hyperhomocysteinemia and venous thromboembolism. | journal=Semin Thromb Hemost | year= 2006 | volume= 32 | issue= 7 | pages= 716-23 | pmid=17024599 | doi=10.1055/s-2006-951456 | pmc= | url= }} </ref>
* [[Hyperhomocysteinemia]]:<ref name="pmid8592549">{{cite journal| author=den Heijer M, Koster T, Blom HJ, Bos GM, Briet E, Reitsma PH et al.| title=Hyperhomocysteinemia as a risk factor for deep-vein thrombosis. | journal=N Engl J Med | year= 1996 | volume= 334 | issue= 12 | pages= 759-62 | pmid=8592549 | doi=10.1056/NEJM199603213341203 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8592549  }} </ref> [[Hyperhomocysteinemia]] can be reduced with [[vitamin B]] supplementation.


'''Smoking'''
===Non-Modifiable Risk Factors===
* Advanced age
* [[Heart failure]]
* [[Thrombophilia]] or [[hypercoagulable state]]
** [[Factor V Leiden]]
** [[Prothrombin G20210A mutation]]
** [[Protein C deficiency]]
** [[Protein S deficiency]]
** [[Antithrombin deficiency]]
** [[Activated protein C resistance]]
** [[Antithrombin III deficiency]]
** [[Factor VIII]] [[mutation]]
** [[Antiphospholipid syndrome]]
** [[Heparin induced thrombocytopenia]]
** [[Nephrotic syndrome]]
** [[Paroxysmal nocturnal hemoglobinuria]]
* [[Polycythemia vera]]


==Non-modifiable risk factors==
===Temporary Risk Factors===
* Age: risk of DVT increases with age.
* [[Pregnancy]] and the peri-partum period
*Inherited [[thrombophilia]]: which include the following disorder
* Active [[cancer]]
**[[Factor V Leiden mutation]]
* [[Central venous catheter]]
**[[Prothrombin]] gene mutation
**[[Protein S deficiency]]
**[[Protein C deficiency]]
**[[Antithrombin]] (AT) deficiency


==Temporary risk factors==
** A previous history of DVT (most significant risk factor).Cushman et al noted a 28-day case-fatality rate of 9.4% after first-time DVT and 15.1% after first-time PE.<ref name="pmid15210384">{{cite journal| author=Cushman M, Tsai AW, White RH, Heckbert SR, Rosamond WD, Enright P et al.| title=Deep vein thrombosis and pulmonary embolism in two cohorts: the longitudinal investigation of thromboembolism etiology. | journal=Am J Med | year= 2004 | volume= 117 | issue= 1 | pages= 19-25 | pmid=15210384 | doi=10.1016/j.amjmed.2004.01.018 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15210384  }} </ref>
** Injury to a deep vein from surgery, fractured bone, or other trauma.
** Prolong Immobilization : It slow down the blood flow in a deep vein. This may occur after surgery, if you're ill and in bed for a long time, or if you're on a long flight.
** Pregnancy and the first 6 weeks after giving birth.
** Recent or ongoing treatment for cancer.
** A central venous catheter, a tube placed in vein to allow easy access to the bloodstream for medical treatment.


===Other Possible Risk Factors===
Other possible factors associated with [[VTE]] include:
* [[Nutrition]] low in fish, fruits, and vegetables<ref name="pmid17179018">{{cite journal| author=Steffen LM, Folsom AR, Cushman M, Jacobs DR, Rosamond WD| title=Greater fish, fruit, and vegetable intakes are related to lower incidence of [[venous thromboembolism]]: the Longitudinal Investigation of Thromboembolism Etiology. | journal=Circulation | year= 2007 | volume= 115 | issue= 2 | pages= 188-95 | pmid=17179018 | doi=10.1161/CIRCULATIONAHA.106.641688 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17179018  }} </ref>
* [[Psychological stress]]<ref name="pmid18045241">{{cite journal| author=Rosengren A, Fredén M, Hansson PO, Wilhelmsen L, Wedel H, Eriksson H| title=Psychosocial factors and [[venous thromboembolism]]: a long-term follow-up study of Swedish men. | journal=J Thromb Haemost | year= 2008 | volume= 6 | issue= 4 | pages= 558-64 | pmid=18045241 | doi=10.1111/j.1538-7836.2007.02857.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18045241  }} </ref>
* [[Cardiovascular]] risk factors such as [[diabetes]] and [[hypercholesterolemia]]<ref name="pmid18086925">{{cite journal| author=Ageno W, Becattini C, Brighton T, Selby R, Kamphuisen PW| title=Cardiovascular risk factors and venous thromboembolism: a meta-analysis. | journal=Circulation | year= 2008 | volume= 117 | issue= 1 | pages= 93-102 | pmid=18086925 | doi=10.1161/CIRCULATIONAHA.107.709204 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18086925  }} </ref>
* [[Acute]] medical illness
* [[Drug abuse]] ([[intravenous]] drugs)<ref name="pmid11260066">{{cite journal| author=McColl MD, Tait RC, Greer IA, Walker ID| title=Injecting drug use is a risk factor for [[deep vein thrombosis]] in women in Glasgow. | journal=Br J Haematol | year= 2001 | volume= 112 | issue= 3 | pages= 641-3 | pmid=11260066 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11260066  }} </ref>
*[[Sickle cell disease]]<ref name="pmid23582935">{{cite journal| author=Naik RP, Streiff MB, Haywood C, Nelson JA, Lanzkron S| title=Venous thromboembolism in adults with sickle cell disease: a serious and under-recognized complication. | journal=Am J Med | year= 2013 | volume= 126 | issue= 5 | pages= 443-9 | pmid=23582935 | doi=10.1016/j.amjmed.2012.12.016 | pmc=PMC3627211 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23582935  }} </ref>
*[[Inflammatory bowel disease]]<ref name="pmid23629820">{{cite journal| author=Koutroumpakis EI, Tsiolakidou G, Koutroubakis IE| title=Risk of venous thromboembolism in patients with inflammatory bowel disease. | journal=Semin Thromb Hemost | year= 2013 | volume= 39 | issue= 5 | pages= 461-8 | pmid=23629820 | doi=10.1055/s-0033-1343886 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23629820  }} </ref>
*[[Antipsychotic drugs]]<ref name="pmid22731933">{{cite journal| author=Jönsson AK, Spigset O, Hägg S| title=Venous thromboembolism in recipients of antipsychotics: incidence, mechanisms and management. | journal=CNS Drugs | year= 2012 | volume= 26 | issue= 8 | pages= 649-62 | pmid=22731933 | doi=10.2165/11633920-000000000-00000 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22731933  }} </ref>
*[[Thrombocytosis]]<ref name="pmid22784217">{{cite journal| author=Ho KM, Yip CB, Duff O| title=Reactive thrombocytosis and risk of subsequent venous thromboembolism: a cohort study. | journal=J Thromb Haemost | year= 2012 | volume= 10 | issue= 9 | pages= 1768-74 | pmid=22784217 | doi=10.1111/j.1538-7836.2012.04846.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22784217  }} </ref>
*[[Varicose veins]]<ref name="pmid22915533">{{cite journal| author=Müller-Bühl U, Leutgeb R, Engeser P, Achankeng EN, Szecsenyi J, Laux G| title=Varicose veins are a risk factor for deep venous thrombosis in general practice patients. | journal=Vasa | year= 2012 | volume= 41 | issue= 5 | pages= 360-5 | pmid=22915533 | doi=10.1024/0301-1526/a000222 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22915533  }} </ref><ref name="pmid24112869">{{cite journal| author=Königsbrügge O, Lötsch F, Reitter EM, Brodowicz T, Zielinski C, Pabinger I et al.| title=Presence of varicose veins in cancer patients increases the risk for occurrence of venous thromboembolism. | journal=J Thromb Haemost | year= 2013 | volume= 11 | issue= 11 | pages= 1993-2000 | pmid=24112869 | doi=10.1111/jth.12408 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24112869  }} </ref>
[[File:.r.png|left|thumb|400px|Courtesy CDC]]
<br style="clear:left" />


==References==
==References==
{{reflist|2}}
{{Reflist|2}}


[[Category:Disease]]
[[Category:Cardiology]]
[[Category:Hematology]]
[[Category:Hematology]]
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[[Category:Cardiology]]
[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
[[Category:Mature chapter]]
[[Category:Vascular surgery]]
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Latest revision as of 17:06, 7 March 2018



Resident
Survival
Guide

Editor(s)-In-Chief: The APEX Trial Investigators, C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2] Kashish Goel, M.D.; Assistant Editor(s)-In-Chief: Justine Cadet; Rim Halaby, M.D. [3]

Deep Vein Thrombosis Microchapters

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Overview

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Differentiating Deep vein thrombosis from other Diseases

Epidemiology and Demographics

Risk Factors

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Assessment of Clinical Probability and Risk Scores

Assessment of Probability of Subsequent VTE and Risk Scores

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Risk calculators and risk factors for Deep vein thrombosis risk factors

Overview

Venous thromboembolism (VTE) consists of deep vein thrombosis (DVT), pulmonary embolism (PE), or both. In these chapters on VTE, the word risk factors refers to those epidemiologic and genetic variables that expose someone to a higher risk of developing venous thrombosis. The word triggers refer to those factors in the patients immediate history or environment that may have led to the occurrence of the venous thrombosis. The risk factors for VTE are a constellation of predisposing conditions which stem from the three principles of Virchow's triad: stasis of the blood flow, damage to the vascular endothelial cells, and hypercoagulability. The risk factors for VTE can be classified as temporary, modifiable and non-modifiable. It is suggested that venous thrombosis also shares risk factors with arterial thrombosis, such as obesity, hypertension, smoking, and diabetes mellitus.[1]

Risk Factors

Shown below is a list of predisposing factors to VTE.[2][3] The risk factors are classified as moderate or weak depending on how strongly they predispose for a VTE.

Moderate risk factors Weak risk factors

Chemotherapy
Chronic heart failure
Respiratory failure
Hormone replacement therapy
Cancer
Oral contraceptive pills
Stroke
Pregnancy
Postpartum
❑ Prior history of VTE
Thrombophilia

❑ Advanced age

Laparoscopic surgery
❑ Prepartum
Obesity
Varicose veins


The risk factors of VTE can be further classified into modifiable, non-modifiable and temporary.

Modifiable Risk Factors

Modifiable risk factors are reversible based upon lifestyle/behavior modification.

Non-Modifiable Risk Factors

Temporary Risk Factors


Other Possible Risk Factors

Other possible factors associated with VTE include:

Courtesy CDC


References

  1. Goldhaber SZ (2010). "Risk factors for venous thromboembolism". J Am Coll Cardiol. 56 (1): 1–7. doi:10.1016/j.jacc.2010.01.057. PMID 20620709.
  2. Anderson FA, Spencer FA (2003). "Risk factors for venous thromboembolism". Circulation. 107 (23 Suppl 1): I9–16. doi:10.1161/01.CIR.0000078469.07362.E6. PMID 12814980.
  3. Torbicki A, Perrier A, Konstantinides S, Agnelli G, Galiè N, Pruszczyk P; et al. (2008). "Guidelines on the diagnosis and management of acute pulmonary embolism: the Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC)". Eur Heart J. 29 (18): 2276–315. doi:10.1093/eurheartj/ehn310. PMID 18757870.
  4. 4.0 4.1 Holst AG, Jensen G, Prescott E (2010). "Risk factors for venous thromboembolism: results from the Copenhagen City Heart Study". Circulation. 121 (17): 1896–903. doi:10.1161/CIRCULATIONAHA.109.921460. PMID 20404252.
  5. Vayá A, Martínez-Triguero ML, España F, Todolí JA, Bonet E, Corella D (2011). "The metabolic syndrome and its individual components: its association with venous thromboembolism in a Mediterranean population". Metab Syndr Relat Disord. 9 (3): 197–201. doi:10.1089/met.2010.0117. PMID 21352080.
  6. Eichinger S, Hron G, Bialonczyk C, Hirschl M, Minar E, Wagner O; et al. (2008). "Overweight, obesity, and the risk of recurrent venous thromboembolism". Arch Intern Med. 168 (15): 1678–83. doi:10.1001/archinte.168.15.1678. PMID 18695082.
  7. Pomp ER, Rosendaal FR, Doggen CJ (2008). "Smoking increases the risk of venous thrombosis and acts synergistically with oral contraceptive use". Am J Hematol. 83 (2): 97–102. doi:10.1002/ajh.21059. PMID 17726684.
  8. den Heijer M, Koster T, Blom HJ, Bos GM, Briet E, Reitsma PH; et al. (1996). "Hyperhomocysteinemia as a risk factor for deep-vein thrombosis". N Engl J Med. 334 (12): 759–62. doi:10.1056/NEJM199603213341203. PMID 8592549.
  9. Steffen LM, Folsom AR, Cushman M, Jacobs DR, Rosamond WD (2007). "Greater fish, fruit, and vegetable intakes are related to lower incidence of [[venous thromboembolism]]: the Longitudinal Investigation of Thromboembolism Etiology". Circulation. 115 (2): 188–95. doi:10.1161/CIRCULATIONAHA.106.641688. PMID 17179018. URL–wikilink conflict (help)
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