Issue: 2011 > January > original article

Risk factors of arterial cardiovascular complications in patients with prior venous thromboembolism



ORIGINAL ARTICLE
S. Roshani, W.M. Lijfering, M. Coppens, K. Hamulyák, M.H. Prins, H.R. Büller, S. Middeldorp
AbstractPDF

Abstract

Background. The effect of cardiovascular risk factors
(CVRs) and thrombophilic defects on the risk of arterial
cardiovascular complications in patients with prior venous thromboembolism (VTE) is unclear. Objective. We investigated whether the risk of arterial cardiovascular complications is increased after VTE and
whether CVRs and thrombophilic defects influence this risk. Methods. Subjects were selected from three family
cohorts of probands with VTE or arterial cardiovascular
complication before the age of 50 and thrombophilic
defects (i.e. hyperhomocysteinaemia, prothrombin
G20210A or elevated FVIII). For this analysis, probands
with arterial cardiovascular complications before inclusion and their relatives as well as relatives without the studied thrombophilic defects were excluded. We calculated the incidence of arterial cardiovascular complications (e.g. myocardial infarction, ischaemic stroke, transient ischaemic attack or peripheral arterial disease) in subjects with and without VTE and adjusted the relative risk for at least one CVR, two or more thrombophilic defects and quintiles of a propensity score (considering risk factors conditional to VTE history).
Results. 861 subjects were included, of whom 399 had experienced VTE before inclusion. Twelve arterial
cardiovascular complications occurred in subjects with and nine in subjects without VTE history. Hence the annual incidence was 1.0 (95% CI 0.5 to 1.7) and 0.7 (0.3 to 1.2) in subjects with and without VTE (RR 1.5, 0.6 to 3.6). Adjusting for possible confounders did not change this relative risk. Conclusion. The mildly elevated risk of arterial cardiovascular complications in patients with prior VTE appears to be independent of cardiovascular risk factors and thrombophilic defects.