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Thromb Haemost 2016; 115(01): 135-142
DOI: 10.1160/TH15-01-0045
Stroke, Systemic or Venous Thromboembolism
Schattauer GmbH Schattauer

Risk factors for venous thromboembolism in women under combined oral contraceptive

The PILl Genetic RIsk Monitoring (PILGRIM) Study
Pierre Suchon   *
1   INSERM, UMR1062, ‘Nutrition, Obesity and Risk of Thrombosis’, Aix-Marseille University, Marseille, France
2   Laboratory of Hematology, APHM, Hopital Timone, Marseille, France
,
Fadi Al Frouh   *
1   INSERM, UMR1062, ‘Nutrition, Obesity and Risk of Thrombosis’, Aix-Marseille University, Marseille, France
,
Agathe Henneuse
1   INSERM, UMR1062, ‘Nutrition, Obesity and Risk of Thrombosis’, Aix-Marseille University, Marseille, France
2   Laboratory of Hematology, APHM, Hopital Timone, Marseille, France
,
Manal Ibrahim
2   Laboratory of Hematology, APHM, Hopital Timone, Marseille, France
,
Dominique Brunet
2   Laboratory of Hematology, APHM, Hopital Timone, Marseille, France
,
Marie-Christine Barthet
2   Laboratory of Hematology, APHM, Hopital Timone, Marseille, France
,
Marie-Françoise Aillaud
1   INSERM, UMR1062, ‘Nutrition, Obesity and Risk of Thrombosis’, Aix-Marseille University, Marseille, France
2   Laboratory of Hematology, APHM, Hopital Timone, Marseille, France
,
Geoffroy Venton
3   INSERM, UMR1090 TAGC, Aix-Marseille University, Marseille, France
4   Service d’hématologie, APHM, Hôpital de la Conception, Marseille, France
,
Marie-Christine Alessi
1   INSERM, UMR1062, ‘Nutrition, Obesity and Risk of Thrombosis’, Aix-Marseille University, Marseille, France
2   Laboratory of Hematology, APHM, Hopital Timone, Marseille, France
,
David-Alexandre Trégouët
5   Institut National pour la Santé et la Recherche Médicale (INSERM), Unité Mixte de Recherche en Santé (UMR_S) 1166, Paris, France
6   Institute for Cardiometabolism and Nutrition (ICAN), Paris, France
7   Sorbonne Universités, Université Pierre et Marie Curie (UPMC Univ Paris 06), UMR_S 1166, Team Genomics & Pathophysiology of Cardiovascular Diseases, Paris, France
,
Pierre-Emmanuel Morange
1   INSERM, UMR1062, ‘Nutrition, Obesity and Risk of Thrombosis’, Aix-Marseille University, Marseille, France
2   Laboratory of Hematology, APHM, Hopital Timone, Marseille, France
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Publikationsverlauf

Received: 16. Januar 2015

Accepted after major revision: 03. Juli 2015

Publikationsdatum:
22. November 2017 (online)

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Summary

Identifying women at risk of venous thromboembolism (VTE) is a major public health issue. The objective of this study was to identify environmental and genetic determinants of VTE risk in a large sample of women under combined oral contraceptives (COC). A total of 968 women who had had one event of VTE during COC use were compared to 874 women under COC but with no personal history of VTE. Clinical data were collected and a systematic thrombophilia screening was performed together with ABO blood group assessment. After adjusting for age, family history, and type and duration of COC use, main environmental determinants of VTE were smoking (odds ratio [OR] =1.65, 95 % confidence interval [1.30–2.10]) and a body mass index higher than 35 kg.m-2 (OR=3.46 [1.81–7.03]). In addition, severe inherited thrombophilia (OR=2.13 [1.32–3.51]) and non-O blood groups (OR=1.98 [1.57–2.49]) were strong genetic risk factors for VTE. Family history poorly predicted thrombophilia as its prevalence was similar in patients with or without first degree family history of VTE (29.3 % vs 23.9 %, p=0.09). In conclusion, this study confirms the influence of smoking and obesity and shows for the first time the impact of ABO blood group on the risk of VTE in women under COC. It also confirms the inaccuracy of the family history of VTE to detect inherited thrombophilia.

Keywords

Deep-vein thrombosis - oral contraceptives - thrombophilia

* P. Suchon and F. Al Frouh contributed equally to the manuscript.


 

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