ETHNICITY AND THE EPIDEMIOLOGY OF VENOUS THROMBOEMBOLISM: A POPULATION-BASED STUDY
(Abstract release date: 05/19/16)
EHA Library. Lazo-Langner A. 06/10/16; 135170; S137
Dr. Alejandro Lazo-Langner
Contributions
Contributions
Abstract
Abstract: S137
Type: Oral Presentation
Presentation during EHA21: On Friday, June 10, 2016 from 11:30 - 11:45
Location: Room H4
Background
The epidemiology of Venous thromboembolism (VTE) has been largely studied in White populations, with much less known among non-Caucasians. Differences may exist in the biological predisposition to VTE but little is known about the epidemiology of VTE among immigrants or in relation to ethnicity.
Aims
To generate estimates of the incidence of VTE in immigrants to Ontario, Canada, grouped by their geographical region of origin as a proxy for ethnicity, and estimate risk ratios (RR) for different ethnic groups compared to Whites.
Methods
We conducted a population-based retrospective matched cohort study using linked health care and administrative databases in Ontario, Canada. These datasets were linked using unique, encoded identifiers and analyzed at the Institute for Clinical Evaluative Sciences (ICES) according to a pre-specified protocol that was approved by the research ethics board at Sunnybrook Health Sciences Centre (Toronto, Canada). We identified patients who immigrated to Ontario between Jan. 1, 2000 and Dec. 31, 2010. A non-immigrant comparison cohort was matched based on age, sex and place of residence. The main study exposure was an individual’s ethnicity based on world geographical region of origin using a previously validated algorithm. Patients were divided in the following ethnic groups: 1) White, 2) Black, 3) Latin American, 4) Arab, 5) East Asian (including Chinese, Japanese, Korean, Filipino and other South East Asian), 6) South Asian, and 7) West Asian. Main study outcome was the occurrence of a first VTE. Secondary outcomes included deep vein thrombosis (DVT) and pulmonary embolism (PE). Patients were followed until the occurrence of an outcome, death, emigration from the province or end of follow up period (Dec. 31st, 2014). We calculated age-and sex specific incidence rates (IR) per 1000 person-years (PY). RR were calculated using Poisson regression models.
Results
We included 1,195,791 people in the immigrant and non-immigrant cohorts respectively, with a total period of observation >17,000,000 PY. Overall, the incidence rate for any VTE was 1.25 per 1000 PY (95% CI 1.23 to 1.27). For DVT the IR was 0.97 per 1000 PY (95% CI 0.96 to 0.99) and for PE it was 0.36 per 1000 PY (95% CI 0.35 to 0.37). The IR for VTE was lower among immigrants (0.87 per 1000 PY; 95% CI 0.85 to 0.89) than non-immigrants (1.59 per 1000 PY; 95% CI 1.56 to 1.61). Compared to white immigrants, the age-specific RR were consistently lower for both men and women of East Asian (RR 0.19-0.33) and South Asian (RR 0.29-0.65) ethnicity across all age groups. For patients of West Asian and Arab ethnicity the age-specific RR were also generally lower except for patients <30 or >80 years old. IR for immigrants of Black and Latin American ethnicity were no different across most age groups. RR for Black women less than 40 years old were higher compared to White immigrants. Among immigrants of Black, Arab and South Asian ethnicity who developed a VTE there was a higher prevalence of a previous delivery or C-section compared to White immigrants.
Conclusion
Incidence of VTE is lower among immigrants compared to non-immigrants in Ontario. Among immigrants, those of East and South Asian ethnicity have a lower risk of VTE compared to whites.This study was supported by the Institute for Clinical Evaluative Sciences (ICES), which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). The opinions, results and conclusions reported in this paper are those of the authors and are independent from the funding sources. No endorsement by ICES or the Ontario MOHLTC is intended or should be inferred. AL-L was supported for this study by a grant from the Academic Medical Organization of South Western Ontario Opportunities fund and by the ICES Western Faculty Scholars program.
Session topic: Thrombosis
Keyword(s): Epidemiology, Ethnicity, Venous thromboembolism
Type: Oral Presentation
Presentation during EHA21: On Friday, June 10, 2016 from 11:30 - 11:45
Location: Room H4
Background
The epidemiology of Venous thromboembolism (VTE) has been largely studied in White populations, with much less known among non-Caucasians. Differences may exist in the biological predisposition to VTE but little is known about the epidemiology of VTE among immigrants or in relation to ethnicity.
Aims
To generate estimates of the incidence of VTE in immigrants to Ontario, Canada, grouped by their geographical region of origin as a proxy for ethnicity, and estimate risk ratios (RR) for different ethnic groups compared to Whites.
Methods
We conducted a population-based retrospective matched cohort study using linked health care and administrative databases in Ontario, Canada. These datasets were linked using unique, encoded identifiers and analyzed at the Institute for Clinical Evaluative Sciences (ICES) according to a pre-specified protocol that was approved by the research ethics board at Sunnybrook Health Sciences Centre (Toronto, Canada). We identified patients who immigrated to Ontario between Jan. 1, 2000 and Dec. 31, 2010. A non-immigrant comparison cohort was matched based on age, sex and place of residence. The main study exposure was an individual’s ethnicity based on world geographical region of origin using a previously validated algorithm. Patients were divided in the following ethnic groups: 1) White, 2) Black, 3) Latin American, 4) Arab, 5) East Asian (including Chinese, Japanese, Korean, Filipino and other South East Asian), 6) South Asian, and 7) West Asian. Main study outcome was the occurrence of a first VTE. Secondary outcomes included deep vein thrombosis (DVT) and pulmonary embolism (PE). Patients were followed until the occurrence of an outcome, death, emigration from the province or end of follow up period (Dec. 31st, 2014). We calculated age-and sex specific incidence rates (IR) per 1000 person-years (PY). RR were calculated using Poisson regression models.
Results
We included 1,195,791 people in the immigrant and non-immigrant cohorts respectively, with a total period of observation >17,000,000 PY. Overall, the incidence rate for any VTE was 1.25 per 1000 PY (95% CI 1.23 to 1.27). For DVT the IR was 0.97 per 1000 PY (95% CI 0.96 to 0.99) and for PE it was 0.36 per 1000 PY (95% CI 0.35 to 0.37). The IR for VTE was lower among immigrants (0.87 per 1000 PY; 95% CI 0.85 to 0.89) than non-immigrants (1.59 per 1000 PY; 95% CI 1.56 to 1.61). Compared to white immigrants, the age-specific RR were consistently lower for both men and women of East Asian (RR 0.19-0.33) and South Asian (RR 0.29-0.65) ethnicity across all age groups. For patients of West Asian and Arab ethnicity the age-specific RR were also generally lower except for patients <30 or >80 years old. IR for immigrants of Black and Latin American ethnicity were no different across most age groups. RR for Black women less than 40 years old were higher compared to White immigrants. Among immigrants of Black, Arab and South Asian ethnicity who developed a VTE there was a higher prevalence of a previous delivery or C-section compared to White immigrants.
Conclusion
Incidence of VTE is lower among immigrants compared to non-immigrants in Ontario. Among immigrants, those of East and South Asian ethnicity have a lower risk of VTE compared to whites.This study was supported by the Institute for Clinical Evaluative Sciences (ICES), which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). The opinions, results and conclusions reported in this paper are those of the authors and are independent from the funding sources. No endorsement by ICES or the Ontario MOHLTC is intended or should be inferred. AL-L was supported for this study by a grant from the Academic Medical Organization of South Western Ontario Opportunities fund and by the ICES Western Faculty Scholars program.
Session topic: Thrombosis
Keyword(s): Epidemiology, Ethnicity, Venous thromboembolism
Abstract: S137
Type: Oral Presentation
Presentation during EHA21: On Friday, June 10, 2016 from 11:30 - 11:45
Location: Room H4
Background
The epidemiology of Venous thromboembolism (VTE) has been largely studied in White populations, with much less known among non-Caucasians. Differences may exist in the biological predisposition to VTE but little is known about the epidemiology of VTE among immigrants or in relation to ethnicity.
Aims
To generate estimates of the incidence of VTE in immigrants to Ontario, Canada, grouped by their geographical region of origin as a proxy for ethnicity, and estimate risk ratios (RR) for different ethnic groups compared to Whites.
Methods
We conducted a population-based retrospective matched cohort study using linked health care and administrative databases in Ontario, Canada. These datasets were linked using unique, encoded identifiers and analyzed at the Institute for Clinical Evaluative Sciences (ICES) according to a pre-specified protocol that was approved by the research ethics board at Sunnybrook Health Sciences Centre (Toronto, Canada). We identified patients who immigrated to Ontario between Jan. 1, 2000 and Dec. 31, 2010. A non-immigrant comparison cohort was matched based on age, sex and place of residence. The main study exposure was an individual’s ethnicity based on world geographical region of origin using a previously validated algorithm. Patients were divided in the following ethnic groups: 1) White, 2) Black, 3) Latin American, 4) Arab, 5) East Asian (including Chinese, Japanese, Korean, Filipino and other South East Asian), 6) South Asian, and 7) West Asian. Main study outcome was the occurrence of a first VTE. Secondary outcomes included deep vein thrombosis (DVT) and pulmonary embolism (PE). Patients were followed until the occurrence of an outcome, death, emigration from the province or end of follow up period (Dec. 31st, 2014). We calculated age-and sex specific incidence rates (IR) per 1000 person-years (PY). RR were calculated using Poisson regression models.
Results
We included 1,195,791 people in the immigrant and non-immigrant cohorts respectively, with a total period of observation >17,000,000 PY. Overall, the incidence rate for any VTE was 1.25 per 1000 PY (95% CI 1.23 to 1.27). For DVT the IR was 0.97 per 1000 PY (95% CI 0.96 to 0.99) and for PE it was 0.36 per 1000 PY (95% CI 0.35 to 0.37). The IR for VTE was lower among immigrants (0.87 per 1000 PY; 95% CI 0.85 to 0.89) than non-immigrants (1.59 per 1000 PY; 95% CI 1.56 to 1.61). Compared to white immigrants, the age-specific RR were consistently lower for both men and women of East Asian (RR 0.19-0.33) and South Asian (RR 0.29-0.65) ethnicity across all age groups. For patients of West Asian and Arab ethnicity the age-specific RR were also generally lower except for patients <30 or >80 years old. IR for immigrants of Black and Latin American ethnicity were no different across most age groups. RR for Black women less than 40 years old were higher compared to White immigrants. Among immigrants of Black, Arab and South Asian ethnicity who developed a VTE there was a higher prevalence of a previous delivery or C-section compared to White immigrants.
Conclusion
Incidence of VTE is lower among immigrants compared to non-immigrants in Ontario. Among immigrants, those of East and South Asian ethnicity have a lower risk of VTE compared to whites.This study was supported by the Institute for Clinical Evaluative Sciences (ICES), which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). The opinions, results and conclusions reported in this paper are those of the authors and are independent from the funding sources. No endorsement by ICES or the Ontario MOHLTC is intended or should be inferred. AL-L was supported for this study by a grant from the Academic Medical Organization of South Western Ontario Opportunities fund and by the ICES Western Faculty Scholars program.
Session topic: Thrombosis
Keyword(s): Epidemiology, Ethnicity, Venous thromboembolism
Type: Oral Presentation
Presentation during EHA21: On Friday, June 10, 2016 from 11:30 - 11:45
Location: Room H4
Background
The epidemiology of Venous thromboembolism (VTE) has been largely studied in White populations, with much less known among non-Caucasians. Differences may exist in the biological predisposition to VTE but little is known about the epidemiology of VTE among immigrants or in relation to ethnicity.
Aims
To generate estimates of the incidence of VTE in immigrants to Ontario, Canada, grouped by their geographical region of origin as a proxy for ethnicity, and estimate risk ratios (RR) for different ethnic groups compared to Whites.
Methods
We conducted a population-based retrospective matched cohort study using linked health care and administrative databases in Ontario, Canada. These datasets were linked using unique, encoded identifiers and analyzed at the Institute for Clinical Evaluative Sciences (ICES) according to a pre-specified protocol that was approved by the research ethics board at Sunnybrook Health Sciences Centre (Toronto, Canada). We identified patients who immigrated to Ontario between Jan. 1, 2000 and Dec. 31, 2010. A non-immigrant comparison cohort was matched based on age, sex and place of residence. The main study exposure was an individual’s ethnicity based on world geographical region of origin using a previously validated algorithm. Patients were divided in the following ethnic groups: 1) White, 2) Black, 3) Latin American, 4) Arab, 5) East Asian (including Chinese, Japanese, Korean, Filipino and other South East Asian), 6) South Asian, and 7) West Asian. Main study outcome was the occurrence of a first VTE. Secondary outcomes included deep vein thrombosis (DVT) and pulmonary embolism (PE). Patients were followed until the occurrence of an outcome, death, emigration from the province or end of follow up period (Dec. 31st, 2014). We calculated age-and sex specific incidence rates (IR) per 1000 person-years (PY). RR were calculated using Poisson regression models.
Results
We included 1,195,791 people in the immigrant and non-immigrant cohorts respectively, with a total period of observation >17,000,000 PY. Overall, the incidence rate for any VTE was 1.25 per 1000 PY (95% CI 1.23 to 1.27). For DVT the IR was 0.97 per 1000 PY (95% CI 0.96 to 0.99) and for PE it was 0.36 per 1000 PY (95% CI 0.35 to 0.37). The IR for VTE was lower among immigrants (0.87 per 1000 PY; 95% CI 0.85 to 0.89) than non-immigrants (1.59 per 1000 PY; 95% CI 1.56 to 1.61). Compared to white immigrants, the age-specific RR were consistently lower for both men and women of East Asian (RR 0.19-0.33) and South Asian (RR 0.29-0.65) ethnicity across all age groups. For patients of West Asian and Arab ethnicity the age-specific RR were also generally lower except for patients <30 or >80 years old. IR for immigrants of Black and Latin American ethnicity were no different across most age groups. RR for Black women less than 40 years old were higher compared to White immigrants. Among immigrants of Black, Arab and South Asian ethnicity who developed a VTE there was a higher prevalence of a previous delivery or C-section compared to White immigrants.
Conclusion
Incidence of VTE is lower among immigrants compared to non-immigrants in Ontario. Among immigrants, those of East and South Asian ethnicity have a lower risk of VTE compared to whites.This study was supported by the Institute for Clinical Evaluative Sciences (ICES), which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). The opinions, results and conclusions reported in this paper are those of the authors and are independent from the funding sources. No endorsement by ICES or the Ontario MOHLTC is intended or should be inferred. AL-L was supported for this study by a grant from the Academic Medical Organization of South Western Ontario Opportunities fund and by the ICES Western Faculty Scholars program.
Session topic: Thrombosis
Keyword(s): Epidemiology, Ethnicity, Venous thromboembolism
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