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Cigarette smoking and the risk of venous thromboembolism: the Tromsø Study.

Abstract

BACKGROUND

Conflicting findings have been reported on the association between smoking and the risk of venous thromboembolism (VTE).

OBJECTIVES

To conduct a prospective, population-based cohort study to investigate the association between cigarette smoking and the risk of incident VTE.

PATIENTS/METHODS

Information on smoking habits was assessed by self-administered questionnaires in 24 576 subjects, aged 25-96 years, participating in the fourth Tromsø Study in 1994-1995. Incident cases of VTE were registered until the end of follow-up at 1 September 2007.

RESULTS

A total of 389 incident VTE events (1.61 per 1000 person-years) were registered during follow-up (median of 12.5 years). Heavy smokers (> 20 pack-years) had a hazard ratio (HR) of 1.46 (95% confidence interval [CI] 1.04-2.05) for total VTE, and and an HR of 1.75 (95% CI 1.14-2.69) for provoked VTE, as compared with never smokers. The risk of provoked VTE increased with more pack-years of smoking (P = 0.02). Smoking was not associated with risk of unprovoked VTE. The number of pack-years was associated with increased risk of cancer and myocardial infarction, whereas the association between pack-years of smoking and VTE disappeared when failure times were censored at the occurrence of cancer or myocardial infarction.

CONCLUSIONS

Heavy smoking was apparently a risk factor for provoked VTE in analyses with VTE events as the only outcome. The lack of association between smoking and risk of VTE in analyses censored at the occurrence of cancer or myocardial infarction may suggest that smoking-attributable diseases or other predisposing factors are essential for smoking to convey a risk of VTE.

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  • Authors+Show Affiliations

    ,

    Hematological Research Group (HERG), Department of Clinical Medicine, University of Tromsø, Norway. kristin.f.enga@uit.no

    , , , ,

    Source

    MeSH

    Adult
    Aged
    Aged, 80 and over
    Female
    Habits
    Humans
    Incidence
    Male
    Middle Aged
    Multivariate Analysis
    Myocardial Infarction
    Neoplasms
    Norway
    Proportional Hazards Models
    Prospective Studies
    Risk Assessment
    Risk Factors
    Smoking
    Surveys and Questionnaires
    Venous Thromboembolism

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    22882779

    Citation

    Enga, K F., et al. "Cigarette Smoking and the Risk of Venous Thromboembolism: the Tromsø Study." Journal of Thrombosis and Haemostasis : JTH, vol. 10, no. 10, 2012, pp. 2068-74.
    Enga KF, Braekkan SK, Hansen-Krone IJ, et al. Cigarette smoking and the risk of venous thromboembolism: the Tromsø Study. J Thromb Haemost. 2012;10(10):2068-74.
    Enga, K. F., Braekkan, S. K., Hansen-Krone, I. J., le Cessie, S., Rosendaal, F. R., & Hansen, J. B. (2012). Cigarette smoking and the risk of venous thromboembolism: the Tromsø Study. Journal of Thrombosis and Haemostasis : JTH, 10(10), pp. 2068-74. doi:10.1111/j.1538-7836.2012.04880.x.
    Enga KF, et al. Cigarette Smoking and the Risk of Venous Thromboembolism: the Tromsø Study. J Thromb Haemost. 2012;10(10):2068-74. PubMed PMID: 22882779.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Cigarette smoking and the risk of venous thromboembolism: the Tromsø Study. AU - Enga,K F, AU - Braekkan,S K, AU - Hansen-Krone,I J, AU - le Cessie,S, AU - Rosendaal,F R, AU - Hansen,J-B, PY - 2012/8/14/entrez PY - 2012/8/14/pubmed PY - 2013/3/1/medline SP - 2068 EP - 74 JF - Journal of thrombosis and haemostasis : JTH JO - J. Thromb. Haemost. VL - 10 IS - 10 N2 - BACKGROUND: Conflicting findings have been reported on the association between smoking and the risk of venous thromboembolism (VTE). OBJECTIVES: To conduct a prospective, population-based cohort study to investigate the association between cigarette smoking and the risk of incident VTE. PATIENTS/METHODS: Information on smoking habits was assessed by self-administered questionnaires in 24 576 subjects, aged 25-96 years, participating in the fourth Tromsø Study in 1994-1995. Incident cases of VTE were registered until the end of follow-up at 1 September 2007. RESULTS: A total of 389 incident VTE events (1.61 per 1000 person-years) were registered during follow-up (median of 12.5 years). Heavy smokers (> 20 pack-years) had a hazard ratio (HR) of 1.46 (95% confidence interval [CI] 1.04-2.05) for total VTE, and and an HR of 1.75 (95% CI 1.14-2.69) for provoked VTE, as compared with never smokers. The risk of provoked VTE increased with more pack-years of smoking (P = 0.02). Smoking was not associated with risk of unprovoked VTE. The number of pack-years was associated with increased risk of cancer and myocardial infarction, whereas the association between pack-years of smoking and VTE disappeared when failure times were censored at the occurrence of cancer or myocardial infarction. CONCLUSIONS: Heavy smoking was apparently a risk factor for provoked VTE in analyses with VTE events as the only outcome. The lack of association between smoking and risk of VTE in analyses censored at the occurrence of cancer or myocardial infarction may suggest that smoking-attributable diseases or other predisposing factors are essential for smoking to convey a risk of VTE. SN - 1538-7836 UR - https://www.unboundmedicine.com/medline/citation/22882779/Cigarette_smoking_and_the_risk_of_venous_thromboembolism:_the_Tromsø_Study_ L2 - https://doi.org/10.1111/j.1538-7836.2012.04880.x DB - PRIME DP - Unbound Medicine ER -