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Risk of deep vein thrombosis and pulmonary embolism in asthma

Christof J. Majoor, Pieter W. Kamphuisen, Aeilko H. Zwinderman, Anneke ten Brinke, Marijke Amelink, Lucia Rijssenbeek-Nouwens, Peter J. Sterk, Harry R. Büller, Elisabeth H. Bel
European Respiratory Journal 2013 42: 655-661; DOI: 10.1183/09031936.00150312
Christof J. Majoor
1Dept of Respiratory Medicine, Academic Medical Centre, Amsterdam
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  • For correspondence: c.j.majoor@amc.uva.nl
Pieter W. Kamphuisen
2Dept of Vascular Medicine, University Medical Centre Groningen, Groningen
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Aeilko H. Zwinderman
3Dept of Clinical Epidemiology and Biostatistics, Academic Medical Centre, Amsterdam
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Anneke ten Brinke
4Dept of Respiratory Medicine, Medisch Centrum Leeuwarden, Leeuwarden
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Marijke Amelink
1Dept of Respiratory Medicine, Academic Medical Centre, Amsterdam
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Lucia Rijssenbeek-Nouwens
5Dutch Asthma Centre, Davos Dorf, Switzerland
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Peter J. Sterk
1Dept of Respiratory Medicine, Academic Medical Centre, Amsterdam
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Harry R. Büller
6Dept of Vascular Medicine, Academic Medical Centre, Amsterdam, The Netherlands
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Elisabeth H. Bel
1Dept of Respiratory Medicine, Academic Medical Centre, Amsterdam
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  • Article
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  • Figure 1–
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    Figure 1–

    Flow diagram of study patients.

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    Figure 2–

    Cumulative hazards for a) venous thromboembolism, b) pulmonary embolism, and c) deep vein thrombosis in asthma of different severities and the general population. Data for the general population was obtained from Naess et al. [12].

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  • Table 1– Baseline characteristics
    Mild-to-moderate asthmaSevere asthma
    Patients n365283
    Age years50 (18–88)51 (17–77)
    Female sex5861
    BMI kg·m−228 (17–45)27 (18–59)
    Age of asthma onset years#39 (0–78)27 (0–70)
    Duration of asthma years#5.0 (0.1–78)20 (0.1–76)
    Atopy4249
    Smoking history#
     Never-smoker5264
     Ex-smoker4033
     Current smoker83
    Severe exacerbations in previous year
     <1 per year7328
     1–2 per year1931
     >2 per year841
    FEV1 post-bronchodilator % pred97.0 (22–146)84.9 (23.1–133)
    ICS dose ≥1000 μg·day−1085
    Chronic oral corticosteroid038
    Omalizumab07
    • Data are presented as median (range) or %, unless otherwise stated. BMI: body mass index; FEV1: forced expiratory volume in 1 s; % pred: % predicted; ICS: inhaled corticosteroid. #: data derived from questionnaires; not objectively confirmed in 26 patients.

  • Table 2– Venous thromboembolic events (VTEs) in study population
    Mild-to-moderate asthmaSevere asthma
    Patients365283
    Total number of person-years17 91413 975
    Before and after asthma onset
     All VTEs1718
     Only DVT115
     PE ± DVT613
    Before asthma onset
     All VTEs102
     Only DVT81
     PE ± DVT21
    After onset of asthma
     All VTEs716
     Only DVT34
     PE ± DVT412
    • Data are presented as n. DVT: deep venous thrombosis; PE: pulmonary embolism.

  • Table 3– Rate ratios for first pulmonary embolism (PE) and deep vein thrombosis (DVT) events in our asthma population versus the general population
    Mild-to-moderate asthmaSevere asthma
    Patients n365283
    All VTEs (definite and probable)
     DVT1.45 (0.30–4.23)1.62 (0.44–4.14)
     PE3.56 (0.97–9.12)8.93 (4.62–15.63)
    All definite VTEs
     DVT1.45 (0.30–4.23)1.21 (0.25–3.55)
     PE2.67 (0.55–7.80)8.93 (4.62–15.63)
    • Data are presented as rate ratio (95% CI), unless otherwise stated. VTE: venous thromboembolic event.

Additional Files

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    • Supplementary methods and data
    • Figure E1 - Translation of the provided questionnaire in the study.
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European Respiratory Journal: 42 (3)
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Risk of deep vein thrombosis and pulmonary embolism in asthma
Christof J. Majoor, Pieter W. Kamphuisen, Aeilko H. Zwinderman, Anneke ten Brinke, Marijke Amelink, Lucia Rijssenbeek-Nouwens, Peter J. Sterk, Harry R. Büller, Elisabeth H. Bel
European Respiratory Journal Sep 2013, 42 (3) 655-661; DOI: 10.1183/09031936.00150312

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Risk of deep vein thrombosis and pulmonary embolism in asthma
Christof J. Majoor, Pieter W. Kamphuisen, Aeilko H. Zwinderman, Anneke ten Brinke, Marijke Amelink, Lucia Rijssenbeek-Nouwens, Peter J. Sterk, Harry R. Büller, Elisabeth H. Bel
European Respiratory Journal Sep 2013, 42 (3) 655-661; DOI: 10.1183/09031936.00150312
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