The link between venous thromboembolism and atherothrombosis: epidemiology, pathophysiology, and implications for clinical care

Venous thromboembolism (VTE), comprised of deep vein thrombosis (DVT) and pulmonary embolism (PE), remains a significant public health burden in the USA with an estimated 1 200 000 VTE cases in 2020. Atherothrombosis refers to thrombosis in the setting of atherosclerotic cardiovascular disease and includes type I myocardial infarction (MI), ischaemic stroke, and acute limb events with an estimated 720 000 MIs annually in the USA. Despite the historical view of VTE and atherothrombosis as unrelated entities recognized by 'red vs. white clots', these conditions are closely interconnected and share many pathophysiological features and clinical risk factors. This review provides a critical appraisal of the current evidence for the relationship between VTE and atherothrombosis, exploring potential mechanisms and risk factors linking the disorders, recent discoveries from basic and translational research, clinical investigation highlighting their commonalities, as well as the therapies that address both.