The epidemiology of venous thromboembolism in Caucasians and African-Americans: the GATE Study1

Authors

  • N. F. Dowling,

    1. *Haematologic Diseases Branch, Division of AIDS, STD, and TB Laboratory Research, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA; †Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; and ‡Mount Sinai School of Medicine, New York, NY, USA
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  • H. Austin,

    1. *Haematologic Diseases Branch, Division of AIDS, STD, and TB Laboratory Research, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA; †Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; and ‡Mount Sinai School of Medicine, New York, NY, USA
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  • A. Dilley,

    1. *Haematologic Diseases Branch, Division of AIDS, STD, and TB Laboratory Research, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA; †Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; and ‡Mount Sinai School of Medicine, New York, NY, USA
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  • C. Whitsett,

    1. *Haematologic Diseases Branch, Division of AIDS, STD, and TB Laboratory Research, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA; †Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; and ‡Mount Sinai School of Medicine, New York, NY, USA
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  • B. L. Evatt,

    1. *Haematologic Diseases Branch, Division of AIDS, STD, and TB Laboratory Research, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA; †Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; and ‡Mount Sinai School of Medicine, New York, NY, USA
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  • W. C. Hooper

    1. *Haematologic Diseases Branch, Division of AIDS, STD, and TB Laboratory Research, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA; †Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; and ‡Mount Sinai School of Medicine, New York, NY, USA
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  • 1

    Use of trade names is for identification only and does not constitute endorsement by the U.S. Department of Health and Human Services, the Public Health Service, or the Centers for Disease Control and Prevention.

Dr Nicole F. Dowling, Centers for Disease Control and Prevention, 1600 Clifton Road, N.E., Mailstop E-64, Atlanta, GA 30333, USA.Tel.: + 404 371 5261, fax: + 404 371 5424, e-mail: ndowling@cdc.gov

Abstract

Summary.  The aim of this study was to assess, comprehensively, medical and genetic attributes of venous thromboembolism (VTE) in a multiracial American population. The Genetic Attributes and Thrombosis Epidemiology (GATE) study is an ongoing case–control study in Atlanta, Georgia, designed to examine racial differences in VTE etiology and pathogenesis. Between 1998 and 2001, 370 inpatients with confirmed VTE, and 250 control subjects were enrolled. Data collected included blood specimens for DNA and plasma analysis and a medical lifestyle history questionnaire. Comparing VTE cases, cancer, recent surgery, and immobilization were more common in caucasian cases, while hypertension, diabetes, and kidney disease were more prevalent in African-American cases. Family history of VTE was reported with equal frequency by cases of both races (28–29%). Race-adjusted odds ratios for the associations of factor V Leiden and prothrombin G20210A mutations were 3.1 (1.5, 6.7) and 1.9 (0.8, 4.4), respectively. Using a larger external comparison group, the odds ratio for the prothrombin mutation among Caucasians was a statistically significant 2.5 (1.4, 4.3). A case-only analysis revealed a near significant interaction between the two mutations among Caucasians. We found that clinical characteristics of VTE patients differed across race groups. Family history of VTE was common in white and black patients, yet known genetic risk factors for VTE are rare in African-American populations. Our findings underscore the need to determine gene polymorphisms associated with VTE in African-Americans.

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