Venous thromboembolism (VTE) is a major health problem. The recent Surgeon General's Call to Action identified the reasons for the persistent occurrence of VTE as critical barriers to progress in the field. This project will address this question at the population level and shift clinical practice paradigms for primary and secondary VTE prevention by development and validating risk prediction tools to target specific subsets of high VTE-risk individuals.
Our specific aims will address current gaps in knowledge by:
(Aim 1) estimating (1a) secular trends in (i) VTE incidence and attack (incident and recurrent VTE) rates, (ii) prevalence and (iii) population attributable risk for each VTE risk factor, and (1b) estimating (i) transition probabilities in a multi-state model for incident and recurrent VTE and death after VTE and (ii) trends in survival after VTE to help inform public policy;
(Aim 2) derivin and validating an overall VTE recurrence prediction score, including germline genetic variation (F5 rs6025, F2 rs1799963, ABO rs8176719);
and (Aim 3) deriving and validating risk and prediction scores for (a) incident and (b) recurrent VTE among active cancer patients, respectively, including plasma biomarkers, germline genetic variation, and cancer tissue procoagulant (tissue factor) antigen expression for both scores. We will use data from previously completed case-control and case-cohort studies to derive the risk and prediction scores, and the longitudinal resources of the Rochester Epidemiology Project and the Mayo Clinic Cancer Registry to perform cohort studies of the entire population of Olmsted County and a large cohort of active cancer patients, respectively, for validation of the scores. The ability t identify high-risk subsets of individuals within: a) the general population (Aim 1), b) those with an incident VTE (aim 2), and c) those with active cancer (Aim 3) will facilitate targeted primary and secondary VTE prevention in a cost-effective and safe manner.

Public Health Relevance

Almost one-half million people suffer venous thromboembolism annually in the United States, and one- third die from this disease. This study aims to prevent the deaths and suffering associated with venous thromboembolism by identifying the individual person at high risk and preventing venous thromboembolism.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL066216-15
Application #
9259808
Study Section
Special Emphasis Panel (ZRG1-PSE-K (90)S)
Program Officer
Pandey, Mona
Project Start
2001-04-01
Project End
2020-05-31
Budget Start
2017-06-01
Budget End
2018-05-31
Support Year
15
Fiscal Year
2017
Total Cost
$694,655
Indirect Cost
$257,765
Name
Mayo Clinic, Rochester
Department
Type
Other Domestic Non-Profits
DUNS #
006471700
City
Rochester
State
MN
Country
United States
Zip Code
55905
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Petterson, Tanya M; Smith, Carin Y; Emerson, Jane A et al. (2018) Venous Thromboembolism (VTE) Incidence and VTE-Associated Survival among Olmsted County Residents of Local Nursing Homes. Thromb Haemost 118:1316-1328
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de Andrade, Mariza; Armasu, Sebastian M; McCauley, Bryan M et al. (2017) Identification of Genetic Interaction with Risk Factors Using a Time-To-Event Model. Int J Environ Res Public Health 14:
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Lindström, Sara; Germain, Marine; Crous-Bou, Marta et al. (2017) Assessing the causal relationship between obesity and venous thromboembolism through a Mendelian Randomization study. Hum Genet 136:897-902
Heit, John A; Crusan, Daniel J; Ashrani, Aneel A et al. (2017) Effect of a near-universal hospitalization-based prophylaxis regimen on annual number of venous thromboembolism events in the US. Blood 130:109-114
Park, Myung S; Spears, Grant M; Bailey, Kent R et al. (2017) Thrombin generation profiles as predictors of symptomatic venous thromboembolism after trauma: A prospective cohort study. J Trauma Acute Care Surg 83:381-387
Ashrani, Aneel A; Gullerud, Rachel E; Petterson, Tanya M et al. (2016) Risk factors for incident venous thromboembolism in active cancer patients: A population based case-control study. Thromb Res 139:29-37

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