April 15 is the Italian National Day against thrombosis: many cities participate in this great project of mobilization, dedicated to the prevention of diseases caused by thrombosis, which affects not only those who are advanced in years, but also teenagers, infants, and children.

 

The event, organized and strongly backed by the non-government organization ALT – Association for the Fight Against Thrombosis and cardiovascular diseases, has a hashtag #ALTpigrizia to engage people of all ages to take a concrete step towards a healthy lifestyle: they can all participate and post photos and selfie on Instagram, Twitter and Facebook.

 

We asked Dr. Lidia Rota, President of ALT and Head of the Cardiovascular Prevention Centre of Humanitas, to explain thrombosis.

 

Thrombosis affects 600,000 people each year in Italy and yet only 33 out of 100 people in Italy know the meaning of the word “thrombosis” How come?

 

“Speaking of thrombosis is to speak of the mechanism that causes heart attack, stroke, embolism, venous and arterial thrombosis. Only in the 80’s doctors began to discover that the heart attack is caused, in most cases, by a thrombus, a blood clot that forms inside a coronary artery and thus narrows the artery. Thrombosis that causes heart attack and stroke from atherosclerosis, progressive inflammatory disease that affects the arteries, facilitated by risk factors such as age, hypertension, diabetes and high level of cholesterol: but yet few take into account that a atherosclerotic vessel clogged because of a blood clot! It seems simple to understand that thrombosis is heart attack, stroke, thrombophlebitis, disease of the veins and arteries, but paradoxically it is very complicated.”

 

What are the causes of thrombosis? Who is more at risk, men or women?

“The diseases from thrombosis by a group of complications, not only from a killer: many complications get on board, the more complications, the bigger chances of the boat to sink. A dramatic event such as heart attack is not caused only by smoking, cholesterol or diabetes: of course, we have to stop smoking, but also increase physical activity to consume cholesterol and reduce the blood pressure if it is high, and reduce abdominal fat and waist: and treat diabetes; we should not work only to normalize blood sugar, but consider the patient as a “whole” in order to prevent a stroke or heart attack, or diseases caused by the same mechanism, but that occur in different areas.”

What are the risk factors of thrombosis?

“The risk increases with age, quite equally between men and women, after the age of 60: most likely to those who have more risk factors simultaneously. Family history, but not only this risk factor, which means having at least a direct blood relative (brother, sister, father, mother) with thrombosis at relatively early age, before 65. Another very obvious risk factor is if one has already had a stroke or another thrombosis-induced illness. Genetic factors are not enough or blaming the bad luck: make the difference and modify the risk factors depending on the lifestyle, that we choose, but which we paradoxically do not always take the responsibility to change.”

Not only the elderly: thrombosis also affects young people and teenagers. Which are the specific causes for these age groups?

“Thrombosis affecting a baby is frightening to tell and see: it is fortunately relatively rare case, but not impossible. As well as when thrombosis affects a child who is being treated for leukemia or another form of cancer, or a young woman who uses contraception as hormonal therapy for the first time has, unknowingly, a mutation that predisposes disorder of the system coagulation, becoming too exuberant in form of clots and thrombi. There are young people affected by stroke so “innocent”, meaning not because of drug abuse, but because they are fragile and do not know it. We are also working for years on these issues in Humanitas, participating in the study IPSYS (Italian Project for Stroke in Young Subjects), which raised the cases of more than two thousand young people, and with the project R.I.T.I (Italian Registry for Thrombosis Children), an instrument funded by ALT, allowing pediatricians with cases of thrombosis in newborns to share the causes, diagnosis, and treatment.”

What is the objective of the Italian Registry for Thrombosis Children?

“The aim of the Registry for thrombosis children is getting information through sharing about individual patients, making diagnosis faster, better, heal better, reduce the chance of losing not only lives, but not leave serious disability in a child. We live in a lucky age: what scientific research has discovered and taught in the field of thrombosis in recent years is extraordinary. Now we, and not only doctors, need to inform, learn to work in an interdisciplinary way with cardiologists, neurologists, vascular surgeons, pediatricians and other specialists dealing with a patient who is a person, and not a disease, and even when we find ourselves in front of a healthy person who does not want to get sick. Prevention of thrombosis-induced diseases has fundamental, real, immediate, low cost effectiveness, which does not require sophisticated tests but conscious patients and informed doctors. It is not easy, but it is possible.”