Metabolic Syndrome Linked to Greater VTE Risk in Deep Vein Thrombosis

blood clot
Depiction of a blood clot forming inside a blood vessel. 3D illustration
All components of metabolic syndrome were linked to greater risk for recurrent venous thromboembolism.

For patients with deep vein thrombosis (DVT), all 4 components of metabolic syndrome (MetS) increase the risk for recurrent venous thromboembolism (VTE), according to study results published in Blood Advances.

The study included patients with DVT from 2004 to 2017 from the Indiana Network for Patient Care, a large statewide database. The researchers analyzed the number of patients who had a comorbid diagnosis of MetS according to International Coding of Diseases components: hypertension, hyperlipidemia, diabetes, or obesity. Using multiple logistic regression models, the researchers calculated associations of MetS components and other variables including age and smoking history with VTE recurrence and mortality rates. They also used Kaplan-Meier curves to assess the risk for VTE recurrence based on the presence or absence of MetS components.

Of 151,054 patients, 17% had recurrence of VTE and 68% had ≥1 comorbid MetS diagnosis. The most common MetS component was hypertension (58%), followed by hyperlipidemia (41%), diabetes (23%), and obesity (19%).

The results indicated that VTE recurrence increased in a stepwise manner with each additional criterion for MetS.

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The researchers found that all 4 components of MetS had significant associations with VTE recurrence. Hyperlipidemia had the largest odds ratio (OR, 1.8; 95% CI, 1.72-1.84), followed by obesity (OR, 1.5; 95% CI, 1.48-1.59), hypertension (OR, 1.5; 95% CI, 1.41-1.53), and diabetes (OR, 1.4; 95% CI, 1.38-1.47).

In Kaplan-Meier curves, all 4 MetS variable remained significant for recurrence of VTE (all P <.0001). Survival analysis produced a hazard ratio of 2.2 (95% CI, 2.12-2.23) for hypertension, 2.3 (95% CI, 2.24-2.36) for hyperlipidemia, 1.8 (95% CI, 1.76-1.86) for diabetes, and 2.2 (95% CI, 2.11-2.24) for obesity.

The researchers noted that the size and scope of the study made data collection challenging, particularly with regard to identification of MetS components. They were also unable to determine what treatment, if any, patients received after DVT diagnosis, and how it may have affected outcomes.

“These findings support the importance of recognizing MetS components in patients diagnosed with acute DVT and initiating appropriate therapies to reduce their effect on VTE recurrence risk,” the researchers wrote.

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Stewart LK, Kline JA. Metabolic syndrome increases risk of venous thromboembolism recurrence after acute deep vein thrombosis. Blood Adv. 2020;4(1):127-135.