Risk Factors for Major Adverse Cardiovascular Events and Major Adverse Limb Events after Venous Thromboembolism: A Large Prospective Cohort Study
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Published:2022-06
Issue:04
Volume:48
Page:465-480
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ISSN:0094-6176
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Container-title:Seminars in Thrombosis and Hemostasis
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language:en
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Short-container-title:Semin Thromb Hemost
Author:
Noumegni Steve Raoul12, Didier Romain23, Mansourati Vincent23, Moigne Emmanuelle Le12, Mao Raphael Le12, Hoffmann Clément12, Moreuil Claire De12, Tromeur Cécile12, Roux Pierre-Yves Le24, Nasr Bahaa5, Gentric Jean-Christophe26, Guegan Marie2, Poulhazan Elise2, Lacut Karine12, Bressollette Luc12, Couturaud Francis12
Affiliation:
1. Departments of Internal Medicine, Vascular Medicine and Pneumology, Brest University Teaching Hospital, Brest Teaching Hospital, Brest, France 2. Western Brittany Thrombosis Study Group, Western Brittany University, Brest, France 3. Department of Cardiology, Brest Teaching Hospital, Brest, France 4. Department of Nuclear Medicine, Brest Teaching Hospital, Brest, France 5. Department of Vascular Surgery, Brest Teaching Hospital, Brest, France 6. Department of Neuroradiology, Brest Teaching Hospital, Brest, France
Abstract
AbstractBackground There is an increased risk of arterial events including major adverse cardiovascular events (MACE) and major adverse limb events (MALE) after venous thromboembolism (VTE). However, their risk factors remain little explored.Methods We aimed to determine the risk factors for MACE (acute coronary syndrome/stroke/cardiovascular death) and MALE (limb ischemia/critical limb ischemia/non-traumatic amputation/any limb revascularization) after VTE. Competing risk models (Fine-Gray) were used in a multicenter prospective cohort of 4,940 patients (mean age: 64.6 years and median follow-up: 64 months).Results MACE occurred in 17.3% of participants (2.35% per patient-years) and MALE in 1.7% (0.27% per patient-years). In multivariable analysis, the identified risk factors for MACE were the age of 50 to 65 years (vs. <50 years, hazard ratio [HR]: 2.00, 95% confidence interval [CI]: 1.38–2.91), age >65 years (vs. <50 years, HR 4.85, 95% CI: 3.35–7.02), pulmonary embolism + deep vein thrombosis (DVT) (vs. isolated-DVT, HR: 1.25, 95% CI: 1.02–1.55), unprovoked-VTE (vs. transient risk factor associated-VTE, HR: 1.29, 95% CI: 1.04–1.59), current tobacco use (vs. never, HR: 1.45, 95% CI: 1.07–1.98), hypertension (HR: 1.61, 95% CI: 1.30–1.98), past history of symptomatic atherosclerosis (HR: 1.52, 95% CI: 1.17–1.98), heart failure (HR: 1.71, 95% CI: 1.21–2.42), atrial fibrillation (HR: 1.55, 95% CI: 1.15–2.08), and vena cava filter insertion (HR: 1.46, 95% CI: 1.03–2.08). The identified risk factors for MALE were the age of 50–65 years (vs. <50 years, HR: 3.49, 95% CI: 1.26–9.65) and atrial fibrillation (HR: 2.37, 95% CI: 1.15–4.89).Conclusions Risk factors for MACE and MALE after VTE included some traditional cardiovascular risk factors, patient's comorbidities, and some characteristics of VTE.
Publisher
Georg Thieme Verlag KG
Subject
Cardiology and Cardiovascular Medicine,Hematology
Cited by
1 articles.
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