Affiliation:
1. Department of Internal Medicine, Vascular Medicine and Pneumology, Brest Teaching Hospital, Brest, France
2. Inserm, UMR 1304 (GETBO), Western Brittany Thrombosis Study Group, Western Brittany University, Brest, France
3. Department of Cardiology, Brest Teaching Hospital, Brest, France
4. Department of Vascular Surgery, Brest Teaching Hospital, Brest, France
5. Department of Neuroradiology, Brest Teaching Hospital, Brest, France
Abstract
Abstract
Background Cardiovascular deaths (CVDTs) are more frequent in patients with venous thromboembolism (VTE) than in the general population; however, risk factors associated with this increased risk of CVDT in patients with VTE are not described.
Methods To determine the risk factors of CVDT in patients with VTE from a multicenter prospective cohort study, Fine and Gray subdistribution hazard models were conducted.
Results Of the 3,988 included patients, 426 (10.7%) died of CVDT during a median follow-up of 5 years. The risk factors of CVDT after multivariate analyses were: age of 50 to 65 years (vs. <50 years, hazard ratio [HR]: 3.22, 95% confidence interval [CI]: 1.67–6.62), age >65 years (vs. <50 years, HR: 7.60, 95% CI: 3.73–15.52), cancer-associated VTE (vs. transient risk factor-related VTE, HR: 1.73, 95% CI: 1.15–2.61), unprovoked VTE (vs. transient risk factor-related VTE, HR: 1.42, 95% CI: 1.02–2.00), past tobacco use (vs. never, HR: 1.43, 95% CI: 1.06–1.94), current tobacco use (vs. never, HR: 1.87, 95% CI: 1.15–3.01), hypertension (HR: 2.11, 95% CI: 1.51–2.96), chronic heart failure (HR: 2.28, 95% CI: 1.37–3.79), chronic respiratory failure (HR: 1.72, 95% CI: 1.02–2.89), and atrial fibrillation (HR: 1.67, 95% CI: 1.06–2.60). The risk of CVDT was significantly reduced with direct oral anticoagulants (vs. vitamin-K antagonists) and with longer duration of treatment (>3 months).
Conclusion Risk factors of CVDT after VTE include some traditional cardiovascular risk factors and other risk factors that are related to characteristics of VTE, and patients' comorbidities.
Funder
Programme Hospitalier de Recherche Clinique”
the Foundation “Archipel Santé
(French Department of Health)
Brest Teaching Hospital
Cited by
3 articles.
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