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Impact of incident venous thromboembolism on risk of arterial thrombotic diseases.
Circulation 2014; 129(8):855-63Circ

Abstract

BACKGROUND

Growing evidence supports an association between venous thromboembolism (VTE) and arterial thrombotic diseases (ie, myocardial infarction and ischemic stroke). We aimed to study the association between VTE and future arterial events and to determine the population attributable risk of arterial events by VTE in a large prospective cohort recruited from the general population.

METHODS AND RESULTS

In 1994 to 1995 and 1993 to 1997, 81 687 subjects were included in the Tromsø Study and in the Diet, Cancer and Health Study and followed up to the date of incident venous and arterial events (myocardial infarction or ischemic stroke), death or migration, or to the end of the study period (2010 and 2008, respectively). There were 1208 cases of VTE and 90 subsequent arterial events during a median follow-up of 12.2 years. An association between VTE and future arterial events was found in all women and men aged <65 years but not in men aged >65 years. Women <65 years old with VTE had 3.3-fold higher risk of arterial disease (adjusted hazard ratio, 3.28; 95% confidence interval, 1.69-6.35) compared with women of the same age without VTE. The corresponding hazard ratio in men aged <65 years was 2.06 (95% confidence interval, 1.32-3.20). Only 0.9% of the arterial events were attributed to VTE, and the VTE explained 63.8% of the risk of arterial events among VTE patients.

CONCLUSIONS

Our findings imply that women and young men with VTE have higher risk of arterial thrombotic disease than those without VTE. However, only 1% of the arterial thrombotic events in the population are attributed to VTE.

Authors+Show Affiliations

Hematological Research Group (C.L., K.F.E., S.K.B., J.-B.H.), Brain and Circulation Research Group (E.B.M.), Department of Clinical Medicine, and Department of Community Medicine (I.N.), University of Tromsø, Tromsø, Norway; Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark (L.E.F., K.O.); Division of Internal Medicine (K.F.E., S.K.B., J.-B.H.) and Department of Neurology and Clinical Neurophysiology (E.B.M.), University Hospital of North Norway, Tromsø, Norway; Department of Haematology (M.T.S.) and Department of Clinical Biochemistry, Cardiovascular Research Center (S.R.K.) and Department of Cardiology (K.O.), Aalborg University Hospital, Aalborg, Denmark; and Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands (S.C.C.).No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

24270266

Citation

Lind, Caroline, et al. "Impact of Incident Venous Thromboembolism On Risk of Arterial Thrombotic Diseases." Circulation, vol. 129, no. 8, 2014, pp. 855-63.
Lind C, Flinterman LE, Enga KF, et al. Impact of incident venous thromboembolism on risk of arterial thrombotic diseases. Circulation. 2014;129(8):855-63.
Lind, C., Flinterman, L. E., Enga, K. F., Severinsen, M. T., Kristensen, S. R., Braekkan, S. K., ... Hansen, J. B. (2014). Impact of incident venous thromboembolism on risk of arterial thrombotic diseases. Circulation, 129(8), pp. 855-63. doi:10.1161/CIRCULATIONAHA.113.004168.
Lind C, et al. Impact of Incident Venous Thromboembolism On Risk of Arterial Thrombotic Diseases. Circulation. 2014 Feb 25;129(8):855-63. PubMed PMID: 24270266.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of incident venous thromboembolism on risk of arterial thrombotic diseases. AU - Lind,Caroline, AU - Flinterman,Linda E, AU - Enga,Kristin F, AU - Severinsen,Marianne T, AU - Kristensen,Søren R, AU - Braekkan,Sigrid K, AU - Mathiesen,Ellisiv B, AU - Njølstad,Inger, AU - Cannegieter,Suzanne C, AU - Overvad,Kim, AU - Hansen,John-Bjarne, Y1 - 2013/11/22/ PY - 2013/11/26/entrez PY - 2013/11/26/pubmed PY - 2014/4/29/medline KW - myocardial infarction KW - stroke KW - venous thrombosis SP - 855 EP - 63 JF - Circulation JO - Circulation VL - 129 IS - 8 N2 - BACKGROUND: Growing evidence supports an association between venous thromboembolism (VTE) and arterial thrombotic diseases (ie, myocardial infarction and ischemic stroke). We aimed to study the association between VTE and future arterial events and to determine the population attributable risk of arterial events by VTE in a large prospective cohort recruited from the general population. METHODS AND RESULTS: In 1994 to 1995 and 1993 to 1997, 81 687 subjects were included in the Tromsø Study and in the Diet, Cancer and Health Study and followed up to the date of incident venous and arterial events (myocardial infarction or ischemic stroke), death or migration, or to the end of the study period (2010 and 2008, respectively). There were 1208 cases of VTE and 90 subsequent arterial events during a median follow-up of 12.2 years. An association between VTE and future arterial events was found in all women and men aged <65 years but not in men aged >65 years. Women <65 years old with VTE had 3.3-fold higher risk of arterial disease (adjusted hazard ratio, 3.28; 95% confidence interval, 1.69-6.35) compared with women of the same age without VTE. The corresponding hazard ratio in men aged <65 years was 2.06 (95% confidence interval, 1.32-3.20). Only 0.9% of the arterial events were attributed to VTE, and the VTE explained 63.8% of the risk of arterial events among VTE patients. CONCLUSIONS: Our findings imply that women and young men with VTE have higher risk of arterial thrombotic disease than those without VTE. However, only 1% of the arterial thrombotic events in the population are attributed to VTE. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/24270266/Impact_of_incident_venous_thromboembolism_on_risk_of_arterial_thrombotic_diseases_ L2 - http://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.113.004168?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -