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However, the mechanisms underlying this relationship remain unknown. We hypothesized that PTSD would associate with increased DVT risk, that neuroimmune mechanisms would mediate the PTSD\u2010DVT link, and that these associations would be stronger in women. This cohort study included <jats:italic>N<\/jats:italic>\u2009=\u2009106\u2009427 participants from a large biobank. PTSD and DVT were defined using ICD\u201010 codes. A subset (<jats:italic>N<\/jats:italic>\u2009=\u20091520) underwent imaging, from which we assessed stress\u2010associated neural activity (SNA). High\u2010sensitivity C\u2010reactive protein (hs\u2010CRP) levels and heart rate variability (HRV) were used as indicators of systemic inflammation and autonomic activity, respectively. Linear, logistic, and Cox regressions and mediation analyses were used to test our hypotheses. Of 106\u2009427 participants, 4192 (3.9%) developed DVT. PTSD associated with increased DVT risk (HR [95% CI]: 1.66 [1.34, 2.07], <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001), and this finding remained significant after adjustment for age, sex, and traditional DVT risk factors. When analyzed separately by sex, PTSD was significantly associated with DVT risk in women but not men. Further, heightened SNA and lower HRV mediated the effect of PTSD on DVT risk. Results suggest that individuals with PTSD are at increased risk for DVT, and that risk is higher in women. This relationship was partially driven by alterations in stress\u2010associated neural activity and autonomic function, suggesting potential targets for preventive therapies. Future studies are needed to investigate whether intervening on PTSD\u2010DVT mechanisms has downstream beneficial effects on DVT, especially among women.<\/jats:p>","DOI":"10.1002\/ajh.27468","type":"journal-article","created":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T13:24:41Z","timestamp":1724937881000},"page":"2279-2285","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Posttraumatic stress disorder increases thrombosis risk: Evidence from a biobank data set"],"prefix":"10.1002","volume":"99","author":[{"given":"Hui","family":"Chong Lau","sequence":"first","affiliation":[{"name":"Cardiovascular Imaging Research Center Massachusetts General Hospital and Harvard Medical School  Boston Massachusetts USA"},{"name":"Cardiology Division Massachusetts General Hospital and Harvard Medical School  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sinead 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