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Blood, 1 August 2007, Vol. 110, No. 3, pp. 908-912. Prepublished online as a Blood First Edition Paper on April 4, 2007; DOI 10.1182/blood-2006-11-057604.
HEMOSTASIS, THROMBOSIS, AND VASCULAR BIOLOGY Sickle cell trait and the risk of venous thromboembolism among blacks1 Emory University, Rollins School of Public Health, Atlanta, GA; 2 University of North Carolina, Chapel Hill; 3 Division of Hereditary Blood Disorders, Centers for Disease Control and Prevention, Atlanta, GA; 4 Emory University, School of Medicine, Atlanta, GA People with sickle cell disease have a chronically activated coagulation system and display hemostatic perturbations, but it is unknown whether they experience an increased risk of venous thromboembolism. We conducted a case–control study of venous thromboembolism that included 515 hospitalized black patients and 555 black controls obtained from medical clinics. All subjects were assayed for hemoglobin S and hemoglobin C genotypes. The prevalence of the S allele was 0.070 and 0.032 for case patients and controls, respectively (P < .001). The odds that a patient had sickle cell trait were approximately twice that of a control, indicating that the risk of venous thromboembolism is increased approximately 2-fold among blacks with sickle cell trait compared with those with the wild-type genotype (odds ratio = 1.8 with 95% confidence interval, 1.2-2.9). The odds ratio for pulmonary embolism and sickle cell trait was higher, 3.9 (2.2-6.9). The prevalence of sickle cell disease was also increased among case patients compared with controls. We conclude that sickle cell trait is a risk factor for venous thromboembolism and that the proportion of venous thromboembolism among blacks attributable to the mutation is approximately 7%.
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