# Presentation: 306760

## The Epidemiology of Venous Thromboembolism:Implications for Prevention and Management

**The Epidemiology of Venous Thromboembolism:****Implications for Prevention and Management**

**John A. Heit, MD**
**Professor of Medicine**
**Director, Coagulation Laboratories & Coagulation Clinic**
**Consultant, Cardiovascular Diseases and Hematology Research**
**Mayo Clinic College of Medicine Rochester, MN**

## Slide 2

## Overall	126	121.2, 130.8

**Age- and Sex-Adjusted Incidence per 100,000***

**Annual incidence/****100,000**

**95% CI**

**Adjusted to the 1990 US white population.**
**	****Silverstein, et al.  Arch Inter Med 1998; 158:585-93. Copyright ****© 1998, American Medical Association.  All right reserved.**
**	****Heit, et al.  J Thromb Haemost 2005**

**Annual Incidence of VTE****in Olmsted County, MN: 1966–1995**

## Annual Incidence of VTEin Olmsted County, MN:  1966-1995By Age and Gender

**CP1198340-1**

**Annual Incidence of VTE****in Olmsted County, MN:  1966-1995****By Age and Gender**

**Annual incidence/100,000**

**Age group (yr)**

**Men**

**Women**

****

## VTE Incidence by Continent of Origin or Ethnicity

## Annual Number of Incident VTE in U.S.

**White Americans 275,000***
**African-Americans 29,000****

**Using the age- and sex-adjusted 1991-1998 incidence, adjusted to year 2000 U.S. White* and African-American** populations, respectively.**

## Cumulative Recurrence of VTE

**Cumulative recurrence (%)**

**Hazard ratio/1,000 person-days**

- 200

- 150

- 100

- 50

- 0

**Years**

- 0

- 1

- 2

- 3

- 4

- 5

- 6

- 7

- 8

- 9

- 10

## Slide 8

## Survival after VTE

## Total US 2002 VTE EventsIncident & Recurrent, Fatal & Non-Fatal

## Total US 2002 VTE Events

_**Total VTE exceed**_**:**
**total myocardial infarctions per year (n=865,000).***
**total strokes per year (n=700,000).***
_**VTE-related deaths exceed**_**:**
**myocardial infarction-related deaths per year (n=171,000; 2003).***
**stroke-related deaths per year (n=158,000; 2003).***
***Data obtained from 2006 AHA “statistics” table**

## Annual Incidence of VTE by Event Type (PE vs. DVT)

**Annual Incidence of VTE ****by Event Type (PE vs. DVT)**

**Silverstein, M.D. et al. Arch Intern Med 1998; 158:585-593.  ***Copyright **© 1998, American Medical Association.  *All rights reserved.

**Notes:**
	KEY POINT: Incidence rates for DVT and PE increase markedly with age.

The Olmstead County, Minn. 25-year population-based study demonstrated that there is a correlation between increasing age and the incidence of VTE.
PE, a potentially fatal complication of DVT, represents an increasing proportion of total VTE events with advancing age.
Results of this study emphasize the need for more effective and safe prophylactic therapy.

Reference
Silverstein MD, Heit JA, Mohr DN, Petterson TM, O’Fallon WM, Melton LJ III. Trends in the 
incidence of deep vein thrombosis and pulmonary embolism: a 25-year population-based study. 
Arch Intern Med. 1998;158:585-593. 

## Slide 13

## Quality of Life after VTEEffect of Post-Thrombotic Syndrome

**Kahn SR, et al.  Arch Intern Med 2005; 165:1173-78, *****Copyright ******©***** *****2005, American Medical Association*****, All rights reserved.**
**Kahn SR, et al.  J Thromb Haemost 2004**

## Venous Thromboembolism Complications:Total US 2002 Incident & Prevalent Venous Stasis Syndrome and Chronic Thromboembolic Pulmonary Hypertension

## Trends in VTE Incidence

**1991-1997:  117.7 per 100,000 person-years**
**1981-1990:  116.0 per 100,000 person-years**

## VTE is common, potentially lethal and often presents as sudden death.
VTE recurs frequently and causes long-term complications that reduce quality of life.
VTE incidence unchanged from 1980-1999.
As US average population age increases, number of VTE events and related deaths per year will increase.

**VTE recurs frequently and causes long-term complications that reduce quality of life.**
**VTE incidence unchanged from 1980-1999.**
**As US average population age increases, number of VTE events and related deaths per year will increase.**

**Epidemiology of VTE ****in the Community**

**Implications for Prevention of VTE**