Risk of myocardial infarction and overall mortality in survivors of venous thromboembolism
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BioMed Central
Open Access
Original clinical investigation
Risk of myocardial infarction and overall mortality in survivors of venous thromboembolism Consuelo Huerta*1, Saga Johansson2,3, Mari-Ann Wallander4 and Luis A García Rodríguez1 Address: 1Spanish Centre for Pharmacoepidemiologic Research (CEIFE), Madrid, Spain, 2AstraZeneca R&D Mölndal, Sweden, 3Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Sweden and 4Department of Public Health and Caring Science, Uppsala University, Sweden Email: Consuelo Huerta* - [email protected]; Saga Johansson - [email protected]; Mari-Ann Wallander - [email protected]; Luis A García Rodríguez - [email protected] * Corresponding author
Published: 18 August 2008 Thrombosis Journal 2008, 6:10
doi:10.1186/1477-9560-6-10
Received: 8 April 2008 Accepted: 18 August 2008
This article is available from: http://www.thrombosisjournal.com/content/6/1/10 © 2008 Huerta et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: Venous thromboembolism (VTE) and thromboembolic arterial diseases are usually considered to be distinct entities, but there is evidence to suggest that these disorders may be linked. The aim of this study was to determine whether a diagnosis of VTE increases the long-term risk of myocardial infarction (MI). Methods: The incidence rate (IR) and relative risk (RR) of MI in a cohort of patients with a diagnosis of VTE (n = 4890) compared with that of a control cohort without prior VTE (n = 43 382) were evaluated in the UK General Practice Research Database (GPRD). Death during followup was also determined. Patients were followed for up to 8 years (mean of 3 years). Results: The IR of MI per 1000 person-years was 4.1 (95% CI: 3.1–5.3) for the VTE cohort and 3.5 (95% CI: 3.2–3.8) for the control cohort. The IR of MI was highest in the first year after the VTE episode, but overall differences between the two cohorts were not significant (RR of MI associated with VTE: 1.2; 95% CI: 0.9–1.6). The risk of death was higher in the VTE cohort than the control cohort, even after adjustment for cancer, heart failure and ischaemic heart disease (RR: 2.4; 95% CI: 2.2–2.6), particularly during the first year after VTE (RR: 3.8; 95% CI: 3.4–4.3). Conclusion: A VTE episode does not significantly increase the risk of MI, but does increase the risk of death, particularly in the first year following VTE diagnosis.
Background Venous thromboembolism (VTE), usually manifested as deep vein thrombosis (DVT) or pulmonary embolism (PE), is usually considered to be a distinct entity from the thromboembolic arterial diseases, such as myocardial infarction (MI), peripheral artery disease and ischaemic
stroke. However, both VTE and thromboembolic arterial diseases involve the format
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