Risk of cardiovascular events in patients diagnosed with venous thromboembolism.

IF 5.3 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

American Journal of Medicine Pub Date : 2025-08-29 DOI:10.1016/j.amjmed.2025.08.035

Frida Lonnberg, Anwar J Siddiqui

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引用次数: 0

Abstract

Background: Cardiovascular disease is a leading cause of mortality globally. Whether venous thromboembolism (VTE) increases the risk of subsequent arterial cardiovascular events (ACVE) remains unclear. We examined the risk of future ACVE in a large emergency department (ED) cohort of patients with and without VTE.

Methods: This retrospective cohort study included all adults (≥18 years) presenting to five EDs in Stockholm 2016-2017. Patients diagnosed with deep vein thrombosis (DVT) or pulmonary embolism (PE) were identified; the remaining patients formed the comparison group. Individuals with prior ACVE were excluded. Fine-Gray subdistribution hazard models estimated crude and adjusted hazard ratios (HRs) for ACVE, cardiovascular death, and all-cause mortality, adjusting for age, sex, and key comorbidities. Mean follow-up was 1.2 years for ACVE and 2.1 years for mortality.

Results: Among 308,779 patients, 3,610 had DVT and 2,358 had PE. ACVE occurred in 70 (1.9%) of DVT and 59 (2.5%) of PE patients, versus 4,870 (1.6%) of patients in the comparison group. Adjusted HRs for ACVE in DVT were 0.77 (95% CI, 0.47-1.25) at 30 days, 0.76 (0.58-0.99) at 1 year, and 0.74 (0.59-0.94) at full follow-up. For PE, the corresponding HRs were 0.46 (0.22-0.96), 0.87 (0.65-1.16), and 0.86 (0.67-1.12), respectively. All-cause mortality was significantly elevated in both groups: HRs for DVT and PE were 1.64 (1.48-1.82) and 2.37 (2.14-2.63), respectively.

Conclusions: VTE was not associated with an increased risk of ACVE. Both DVT and PE were linked to significantly elevated all-cause mortality.

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静脉血栓栓塞患者心血管事件的风险

背景：心血管疾病是全球死亡的主要原因。静脉血栓栓塞（VTE）是否会增加随后动脉心血管事件（ACVE）的风险尚不清楚。我们在一个大型急诊科（ED）队列中检查了有和没有静脉血栓栓塞的患者未来发生ACVE的风险。方法：这项回顾性队列研究纳入了2016-2017年斯德哥尔摩5个急诊科的所有成年人（≥18岁）。诊断为深静脉血栓形成（DVT）或肺栓塞（PE）的患者；其余患者为对照组。排除既往有ACVE的个体。细灰色亚分布风险模型估计了ACVE、心血管死亡和全因死亡率的粗风险比（hr），校正了年龄、性别和主要合共病。ACVE的平均随访时间为1.2年，死亡率的平均随访时间为2.1年。结果：308779例患者中，3610例有DVT， 2358例有PE。ACVE发生在70例（1.9%）DVT患者和59例（2.5%）PE患者中，而对照组为4870例（1.6%）。DVT患者ACVE的调整hr在30天时为0.77 (95% CI, 0.47-1.25)， 1年时为0.76(0.58-0.99)，全随访时为0.74（0.59-0.94）。PE的hr分别为0.46（0.22 ~ 0.96）、0.87（0.65 ~ 1.16）和0.86（0.67 ~ 1.12）。两组的全因死亡率均显著升高：DVT和PE的hr分别为1.64（1.48-1.82）和2.37（2.14-2.63）。结论：静脉血栓栓塞与ACVE风险增加无关。DVT和PE都与全因死亡率显著升高有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Medicine 医学-医学：内科

CiteScore

6.30

自引率

3.40%

发文量

449

审稿时长

9 days

期刊介绍： The American Journal of Medicine - "The Green Journal" - publishes original clinical research of interest to physicians in internal medicine, both in academia and community-based practice. AJM is the official journal of the Alliance for Academic Internal Medicine, a prestigious group comprising internal medicine department chairs at more than 125 medical schools across the U.S. Each issue carries useful reviews as well as seminal articles of immediate interest to the practicing physician, including peer-reviewed, original scientific studies that have direct clinical significance and position papers on health care issues, medical education, and public policy.