Venous thromboembolism (VTE) includes both
deep vein thrombosis (DVT) and pulmonary embolism (PE).
CDC is engaged in several activities related to
preventing VTE, including the following:
- Conducting research to identify genetic and
acquired risk factors of thrombosis.
Many of the known genetic risk
factors for VTE have been discovered in European
populations, including Factor V Leiden and
Prothrombin G20210A polymorphisms, but many genetic
factors have yet to be elucidated among
non-Caucasian populations.
The Genetic Attributes of Thrombosis
Epidemiology (GATE) Study, a cooperative agreement
with Emory University’s Rollins School of Public
Health, aims to address this gap in knowledge by
evaluating genetic variations and hemostatic
biomarkers in a racially diverse population. The
case-control study involves more than 1200 cases of
VTE in both African Americans and Caucasians.
Recently, researchers demonstrated an increase risk
of VTE among those people who have sickle cell
trait.
- Conducting research on the risk of adverse
pregnancy outcomes for those affected by thrombosis
and thrombophilia.
CDC is collaborating with
researchers from Duke University, Robert Wood
Johnson Medical School, and the University of Utah,
to conduct a multi-site, case-control study to
investigate the association between the presence of
maternal and fetal thrombophilic biomarkers and the
occurrence of intrauterine growth restriction.
- Funding of a Thrombosis and Hemostasis Centers
Research and Prevention Network to foster
collaborative epidemiologic research to identify
risks (both genetic and acquired) among a U.S.
population and, ultimately, improve diagnosis and
treatment.
The network was established in July
of 2007 following the work of the Thrombosis and
Hemostasis Centers Pilot Sites. The current funded
centers include: Duke University, the Mayo Clinic,
University of North Carolina at Chapel Hill, Robert
Wood Johnson Medical School, and University of
Colorado.
These centers provide an opportunity
for broad population based research of VTE, as the
current registry includes over 4000 patients,
ranging from newborn to 90 years of age, and
including all racial groups. While about half of
these patients have experienced a VTE, the centers
provide services to patients with other thrombotic
conditions, including thrombophilia, arterial
thrombosis, and pregnancy concerns and management.
The centers are initiating protocols
that will use the DBD laboratory to measure
coagulation and inflammatory genes and proteins that
may be useful in prevention.
- Supporting education and outreach activities to
provide health promotion and wellness programs for
people affected by clotting disorders at both the
community and national level.
- CDC is analyzing national health survey data
to determine public awareness about DVT (i.e.,
does the public know the meaning of VTE/DVT, the
signs and symptoms, and the factors that
predispose to developing VTE/DVT). Information
from this survey will be used to develop
messages to increase DVT awareness that will be
shared with partners.
- CDC is funding a health promotion and
wellness initiative to provide the public with
health information regarding the prevention of
VTE and its complications. CDC is working with
the National Alliance for Thrombosis and
Thrombophilia (NATT), a community-based
organization whose mission is to prevent,
diagnose and treat thrombosis and thrombophilia
through research, education, support and
advocacy, to develop and disseminate health
information for the public, and develop a
training program for non-physician health care
providers.
- Enhancing laboratory research capacity by
providing collaborative services to investigators
ranging from subject matter expertise to laboratory
analysis and assay development and validation
techniques.
- The clinical hemostasis laboratory analyzes
and develops new assays to detect proteins
involved in the coagulation, anticoagulation,
and fibrinolytic pathways using both
high-throughput and robotic platforms.
- The molecular hemostasis laboratory conducts
research in thrombogenetics (the genetics of
thrombosis) and the analysis of
inflammatory-associated proteins. These
activities include high-throughput genotyping,
re-sequencing of candidate genes, and whole
genome scans associated with thromboembolic
disorders.
Although there are estimates on the
prevalence of VTE, a major challenge facing public
health research of VTE is quantifying the true public
health burden. Thus, future activities will include
population-based surveillance of VTE in order to develop
more accurate incidence and prevalence estimates.
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