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Poorly Compressible Lower Extremity Arteries Are Associated with Venous Thromboembolism

1Mayo Clinic Arizona, Cardiovascular Diseases, Scottsdale, United States, 2Mayo Clinic Arizona, Scottsdale, United States, 3Mayo Clinic Arizona, Biomedical Statistics, Scottsdale, United States, 4Mayo Clinic, Rochester, United States

Abstract Number: PB0118

Meeting: ISTH 2020 Congress

Theme: Arterial Thromboembolism » Peripheral Artery Disease

Background: Peripheral artery disease (PAD) impacts millions of people around the globe and is commonly diagnosed using lower extremity physiologic studies. PAD is associated with endothelial dysfunction and inflammation and shares several common risk factors with venous thrombosis. Patients with PAD are at increased risk for vascular complications however, there is little evidence for its association with thrombosis.

Aims: To understand the relationship between arterial occlusive disease and venous thrombosis.

Methods: We reviewed vascular studies between 1996 and August 2018. Based on the ankle brachial index (ABI) recordings, patients were classified into 3 categories: patients with PAD (ABI< 1.0), non-compressible (NC) arteries (ABI>1.4), and patients with normal ABI (1.0-1.4). The main outcome analyzed was new venous thromboembolism. Multivariate Cox proportional regression was used to calculate hazard ratios (HR) with 95% confidence intervals after adjusting for age, gender, and prior history of cancer, or incidence of VTE.

Results: There were 38,016 unique patients (mean age 66.1 ± 14.8 years, female 42.3%) who underwent ABI measurement. Compared to normal ABI, patients with abnormal ABI were more likely to be older and male. Compared to those without PAD, low ABI patients did not have a significantly increased risk of VTE (adjusted HR: 1.06, 95% CI: 1.00-1.11, p=0.04). However, patients with NC vessels had a statistically significant risk of developing VTE compared to patients with normal ABI (adjusted HR: 1.21, 95% CI: 1.12-1.30, p-value< 0.001). Interestingly, NC vessel patients compared to PAD patients had a statistically significant risk of a VTE event (adjusted HR: 1.24, 95% CI: 1.15-1.33, p-value< 0.001).

Conclusions: Compared to patients without PAD those with poorly compressible calcified lower extremity arteries are more prone to develop venous thromboembolic disease. Aggressive treatment of this cohort with anticoagulants might be beneficial.

To cite this abstract in AMA style:

Shamoun F, Bhatt S, Firth C, Marlene G, Abdelmalek M, Tseng A. Poorly Compressible Lower Extremity Arteries Are Associated with Venous Thromboembolism [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/poorly-compressible-lower-extremity-arteries-are-associated-with-venous-thromboembolism/. Accessed September 22, 2023.

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