From the Guidelines
Venous thromboembolism (VTE) in men is commonly caused by a combination of inherited and acquired risk factors, including prolonged immobility, major surgeries, inherited thrombophilias, cancer, obesity, and advancing age. The etiology of VTE in men is multifactorial, and identifying the underlying causes is crucial for effective prevention and management. According to the study by 1, heritable causes of VTE include deficiencies in natural anticoagulants such as antithrombin, Protein C, and Protein S, while acquired causes include cancer, surgery, chemotherapy, autoimmune disease, and certain medications.
Some of the key risk factors for VTE in men include:
- Prolonged immobility, such as during long hospital stays or extended travel
- Major surgeries, particularly orthopedic procedures like hip or knee replacements
- Inherited thrombophilias, such as Factor V Leiden mutation and Protein C or S deficiencies
- Cancer, which can create a hypercoagulable state through the release of procoagulant substances by tumor cells
- Obesity, which contributes to increased inflammation and venous stasis
- Advancing age, which brings progressive vascular changes and decreased mobility
- Previous VTE history, which increases the risk of recurrence
- Certain medications, such as testosterone replacement therapy
- Heart failure and inflammatory conditions, such as inflammatory bowel disease, which can increase the risk of VTE through various mechanisms, including blood stasis and hypercoagulability.
It is essential to note that the risk factors for VTE in men can be modified by an individual's actions, and identifying these factors is crucial for developing effective prevention strategies 1. By understanding the underlying causes of VTE in men, healthcare providers can implement targeted interventions to reduce the risk of this potentially life-threatening condition.
From the FDA Drug Label
The population was 54.7% male, 68.2% White, 20.4% Asian, 1.9% Black and 5. 3% Other. Admitting diagnoses for hospitalization were acute infectious diseases (43.8%) followed by congestive heart failure NYHA class III or IV (33.2%), acute respiratory insufficiency (26.4%), acute ischemic stroke (18.5%) and acute inflammatory diseases (3. 4%). VTE risk factors included severe immobilization at study entry (99.9%), D-dimer > 2× ULN (43.7%), history of heart failure (35.6%), BMI ≥ 35 kg/m 2 (15. 2%), chronic venous insufficiency (14.9%), acute infectious disease (13.9%), severe varicosis (12.5%), history of cancer (16.2%), history of VTE (4.5%), hormone replacement therapy (1.1%), and thrombophilia (0.3%), recent major surgery (0.8%) and recent serious trauma (0.2%).
The common etiology of VTE in men is not explicitly stated in the provided text, but the text does mention various risk factors for VTE that are present in the study population, including:
- Severe immobilization (99.9% of patients)
- History of heart failure (35.6% of patients)
- BMI ≥ 35 kg/m2 (15.2% of patients)
- Chronic venous insufficiency (14.9% of patients)
- Acute infectious disease (13.9% of patients)
- Severe varicosis (12.5% of patients)
- History of cancer (16.2% of patients)
- History of VTE (4.5% of patients) These risk factors may contribute to the development of VTE in men, but the text does not provide a direct answer to the question of common etiology. 2
From the Research
Common Etiology of VTE in Men
- The common etiology of Venous Thromboembolism (VTE) in men includes various risk factors such as:
- Male sex, as mentioned in the study 3
- Increasing age, as stated in the studies 4 and 5
- Immobilization, surgery, trauma, and hospital or nursing home confinement, as mentioned in the study 4
- Malignancy, as discussed in the studies 4, 5, and 6
- Genetic risk factors, such as factor V Leiden, prothrombin G20210A gene mutation, and deficiencies of antithrombin, protein C, and protein S, as mentioned in the studies 3, 4, and 7
- Other risk factors that may contribute to the development of VTE in men include:
- Diabetes, obesity, and smoking, as mentioned in the study 3
- Oral contraceptives and hormonal replacement therapy, as mentioned in the study 3
- Long-haul flight, residual venous thrombosis, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, as mentioned in the study 3
- Antiphospholipid syndrome, as mentioned in the studies 4 and 5
- Cancer, particularly pancreatic, liver, and non-small cell lung cancer, as mentioned in the study 3
Genetic Risk Factors
- Genetic risk factors play a significant role in the development of VTE, as discussed in the study 7
- The study 7 highlights the importance of recognizing and managing high-risk individuals with genetic risk factors for VTE