Thromboembolic disease of the venous and the arterial system: two different entities or two different sides of the same coin?

PhD ceremony: Mr. B.K. Mahmoodi, 13.15 uur, Academiegebouw, Broerstraat 5, Groningen

Title: Thromboembolic disease of the venous and the arterial system: two different entities or two different sides of the same coin?

Promotor(s): prof. J.C. Kluin-Nelemans, prof. G.J. Navis

Faculty: Medical Sciences

In this thesis, special attention was paid to renal disease as different components of the renal disease were previously linked to either VTE (venous thromboembolis) and arterial thromboembolis (ATE). Whereas the association between overt proteinuria and VTE was known for decades, for the first we described the association between tiny amount of albumin in the urine (i.e. microalbuminuria) and VTE. Moreover, for the first time we described that treatment of overt proteinuria with losartan partially reverses the prothrombotic state. Except for overweight or obesity other major cardiovascular risk factors such as elevated blood pressure, elevated cholesterol, diabetes and smoking are probably not risk factors for VTE. On the other hand, deficiencies of the natural anticoagulant protein S or protein C, which are known strong risk factors for VTE, predisposed one also to ATE. Finally, history of VTE itself is a risk factor for subsequent ATE.