Risk of myocardial infarction and overall mortality in survivors of venous thromboembolism

Consuelo Huerta,Saga Johansson,Mari-Ann Wallander,Luis Rodríguez

doi:10.1186/1477-9560-6-10

Abstract

BackgroundVenous thromboembolism (VTE) and thromboembolic arterial diseases are usually considered to be distinct entities, but there is evidence to suggest that these disorders may be linked. The aim of this study was to determine whether a diagnosis of VTE increases the long-term risk of myocardial infarction (MI).MethodsThe incidence rate (IR) and relative risk (RR) of MI in a cohort of patients with a diagnosis of VTE (n = 4890) compared with that of a control cohort without prior VTE (n = 43 382) were evaluated in the UK General Practice Research Database (GPRD). Death during follow-up was also determined. Patients were followed for up to 8 years (mean of 3 years).ResultsThe IR of MI per 1000 person-years was 4.1 (95% CI: 3.1–5.3) for the VTE cohort and 3.5 (95% CI: 3.2–3.8) for the control cohort. The IR of MI was highest in the first year after the VTE episode, but overall differences between the two cohorts were not significant (RR of MI associated with VTE: 1.2; 95% CI: 0.9–1.6). The risk of death was higher in the VTE cohort than the control cohort, even after adjustment for cancer, heart failure and ischaemic heart disease (RR: 2.4; 95% CI: 2.2–2.6), particularly during the first year after VTE (RR: 3.8; 95% CI: 3.4–4.3).ConclusionA VTE episode does not significantly increase the risk of MI, but does increase the risk of death, particularly in the first year following VTE diagnosis.

Highlights

Venous thromboembolism (VTE) and thromboembolic arterial diseases are usually considered to be distinct entities, but there is evidence to suggest that these disorders may be linked
Risk of myocardial infarction The incidence and risk of MI were determined for the cohort of venous thromboembolism (VTE) patients (n = 4890) and the control cohort (n = 43 382), in order to provide an estimate of the relative risk (RR) of MI following VTE
ItFnrioiocgnilduciernonehtcho1eerrtavateecnco(oIuRrsd) itanhngrdotomrebalagoteeivmebroislkism(RR(V)ToEf )mcyoohcoarrtdaianldincfaornc-Incidence rate (IR) and relative risk (RR) of myocardial infarction in the venous thromboembolism (VTE) cohort and control cohort according to age

Summary

Introduction

Venous thromboembolism (VTE) and thromboembolic arterial diseases are usually considered to be distinct entities, but there is evidence to suggest that these disorders may be linked. Venous thromboembolism (VTE), usually manifested as deep vein thrombosis (DVT) or pulmonary embolism (PE), is usually considered to be a distinct entity from the thromboembolic arterial diseases, such as myocardial infarction (MI), peripheral artery disease and ischaemic stroke. Both VTE and thromboembolic arterial diseases involve the formation of clots within blood vessels, and so may be linked. Thrombosis Journal 2008, 6:10 http://www.thrombosisjournal.com/content/6/1/10 rial disease [1,2,3] These studies either lacked a suitable control group or involved relatively small numbers of patients.

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