Introduction: Venous Thromboembolism (VTE) is a serious health issue that could lead to acute, even fatal. Pulmonary Embolism (PE) or Deep Venous Thrombosis (DVT) with the long term morbidity of a post-phlebitic limb. The annual incidence of VTE is approximately 160 per 100 000 for DVT 20 per 100 000 for symptomatic non-fatal PE and 50 per 100 000 for fatal autopsy-detected PE.(1) Virchow in 1856 (2) was the fust to identify that venous stasis, alterations in blood constituents, and changes in the endothelium are the main factors that predispose to VTE. Each of these factors on its own increases the risk. However, their co-existence increases the VTE risk even more. Predisposition to VTE could be also due to inherited or aquired thrombophilia.(3) It also appears that patients with acute coronary syndromes or stroke have an increased risk of VTE as a complication of hospitalization.(4) Prandoni and his collaborators were the first to suggest the association of atherothrombosis and VTE. They subsequently showed that the risk of stroke is also increased by a factor of 2.19 (1.85-2.60) in the first year after an initial VTE event.(5, 6) Piazza and Goldhaber in a recent review demonstrated that myocardial infarction and stroke share the same risk factors with VTE. Namely: Hypertension, Diabetes Mellitus, Dyslipidaemia, the metabolic syndrome, Obesity, Smoking, Stress, Hormone contraception and replacement therapy, Advanced age >75 years, Hyperhomocystenaemia and Sedentary life style. They also showed that this is because they share the same pathophysiology i.e. inflammation, local and systemic hypercoaguability and endothelial injury.
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