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30-year mortality after venous thromboembolism: a population-based cohort study.

https://arctichealth.org/en/permalink/ahliterature257922
Source
Circulation. 2014 Sep 2;130(10):829-36
Publication Type
Article
Date
Sep-2-2014
Author
Kirstine Kobberøe Søgaard
Morten Schmidt
Lars Pedersen
Erzsébet Horváth-Puhó
Henrik Toft Sørensen
Author Affiliation
From the Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark. kks@clin.au.dk.
Source
Circulation. 2014 Sep 2;130(10):829-36
Date
Sep-2-2014
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Cohort Studies
Databases as Topic - statistics & numerical data
Denmark - epidemiology
Female
Humans
Longitudinal Studies
Male
Middle Aged
Regression Analysis
Retrospective Studies
Risk factors
Survival Rate
Venous Thromboembolism - epidemiology - mortality
Abstract
Studies on long-term mortality after venous thromboembolism (VTE) are sparse.
Using Danish medical databases, we conducted a 30-year nationwide population-based cohort study of 128 223 patients with first-time VTE (1980-2011) and a comparison cohort of 640 760 people from the general population (without VTE) randomly matched by sex, year of birth, and calendar period. The mortality risks for patients with deep venous thrombosis (DVT) and pulmonary embolism (PE) were markedly higher than for the comparison cohort during the first year, especially within the first 30 days (3.0% and 31% versus 0.4%). Using Cox regression, we assessed mortality rate ratios (MRRs) with 95% confidence intervals (CIs). The overall 30-year MRR was 1.55 (95% CI, 1.53-1.57) for DVT and 2.77 (95% CI, 2.74-2.81) for PE. The 30-day MRR was 5.38 (95% CI, 5.00-5.80) for DVT and 80.87 (95% CI, 76.02-86.02) for PE. Over time, the 30-day MRR was consistently 5- to 6-fold increased for DVT, whereas it improved for PE from 138 (95% CI, 125-153) in 1980 to 1989 to 36.08 (95% CI, 32.65-39.87) in 2000 to 2011. The 1- to 10-year and 11- to 30-year MRRs remained 25% to 40% increased after both DVT and PE but were 3- to 5-fold increased after DVT and 6- to 11-fold increased after PE when VTE was considered the immediate cause of death.
Patients with VTE are at increased risk of dying, especially within the first year after diagnosis, but also during the entire 30 years of follow-up, with VTE as an important cause of death. Although 30-day mortality after DVT remained fairly constant over the last 3 decades, it improved markedly for PE.
Notes
Comment In: Nat Rev Cardiol. 2014 Sep;11(9):49625027484
Comment In: Nat Rev Cardiol. 2014 Sep;11(9):49725027486
PubMed ID
24970783 View in PubMed
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Impact of incident venous thromboembolism on risk of arterial thrombotic diseases.

https://arctichealth.org/en/permalink/ahliterature105991
Source
Circulation. 2014 Feb 25;129(8):855-63
Publication Type
Article
Date
Feb-25-2014
Author
Caroline Lind
Linda E Flinterman
Kristin F Enga
Marianne T Severinsen
Søren R Kristensen
Sigrid K Braekkan
Ellisiv B Mathiesen
Inger Njølstad
Suzanne C Cannegieter
Kim Overvad
John-Bjarne Hansen
Author Affiliation
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.).
Source
Circulation. 2014 Feb 25;129(8):855-63
Date
Feb-25-2014
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Aged
Atherosclerosis - epidemiology - mortality
Denmark - epidemiology
Female
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
Myocardial Infarction - epidemiology - mortality
Norway - epidemiology
Prospective Studies
Registries - statistics & numerical data
Risk factors
Sex Distribution
Stroke - epidemiology - mortality
Venous Thromboembolism - epidemiology - mortality
Abstract
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.
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. Women
PubMed ID
24270266 View in PubMed
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Incidence of and mortality from venous thromboembolism in a real-world population: the Q-VTE Study Cohort.

https://arctichealth.org/en/permalink/ahliterature112453
Source
Am J Med. 2013 Sep;126(9):832.e13-21
Publication Type
Article
Date
Sep-2013
Author
Vicky Tagalakis
Valérie Patenaude
Susan R Kahn
Samy Suissa
Author Affiliation
Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada. vicky.tagalakis@mcgill.ca
Source
Am J Med. 2013 Sep;126(9):832.e13-21
Date
Sep-2013
Language
English
Publication Type
Article
Keywords
Adult
Aged
Female
Humans
Incidence
Male
Middle Aged
Pulmonary Embolism - epidemiology - mortality
Quebec - epidemiology
Retrospective Studies
Risk factors
Survival Rate
Venous Thromboembolism - epidemiology - mortality
Abstract
The public health burden of venous thromboembolism, which includes deep vein thrombosis and pulmonary embolism, is not fully known, and contemporary incidence and mortality estimates are needed. We determined the incidence and case fatality of venous thromboembolism in a general population.
Using the administrative health care databases of the Canadian province of Québec, we identified all incident cases of deep vein thrombosis or pulmonary embolism between 2000 and 2009 and classified them as definite or probable venous thromboembolism. We formed 2 patient cohorts, one with definite cases and the other including cases with definite or probable venous thromboembolism that were followed until December 31, 2009.
We identified 67,354 definite and 35,123 probable cases of venous thromboembolism. The age- and sex-adjusted incidence rates of definite or probable venous thromboembolism, deep vein thrombosis, and pulmonary embolism were 1.22 (95% confidence interval [CI], 1.22-1.23), 0.78 (95% CI, 0.77-0.79), and 0.45 (95% CI, 0.44-0.45) per 1000 person-years, respectively, while for definite venous thromboembolism it was 0.90 (95% CI, 0.89-0.90) per 1000 person-years. The 30-day and 1-year case-fatality rates after definite or probable venous thromboembolism were 10.6% (95% CI, 10.4-10.8) and 23.0% (95% CI, 22.8-23.3), respectively, and were slightly higher among definite cases. The 1-year survival rate was 0.47 (95% CI, 0.46-0.48) for cases with definite or probable venous thromboembolism and cancer, 0.93 (95% CI, 0.93-0.94) for cases with unprovoked venous thromboembolism, and 0.84 (95% CI, 0.83-0.84) for cases with venous thromboembolism secondary to a major risk factor. Similar survival rates were seen for cases with definite venous thromboembolism.
The risk of venous thromboembolism in the general population remains high, and mortality, especially in cancer patients with venous thromboembolism, is substantial.
PubMed ID
23830539 View in PubMed
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Socioeconomic factors and concomitant diseases are related to the risk for venous thromboembolism during long time follow-up.

https://arctichealth.org/en/permalink/ahliterature117984
Source
J Thromb Thrombolysis. 2013 Jul;36(1):58-64
Publication Type
Article
Date
Jul-2013
Author
Nazim Isma
Juan Merlo
Henrik Ohlsson
Peter J Svensson
Bengt Lindblad
Anders Gottsäter
Author Affiliation
Malmö Centre for Thrombosis and Haemostasis, University of Lund, Skåne University Hospital, 20502 Malmö, Sweden. nazim.isma@med.lu.se
Source
J Thromb Thrombolysis. 2013 Jul;36(1):58-64
Date
Jul-2013
Language
English
Publication Type
Article
Keywords
Adult
Female
Follow-Up Studies
Humans
Male
Marital status
Middle Aged
Proportional Hazards Models
Risk factors
Socioeconomic Factors
Sweden - epidemiology
Venous Thromboembolism - epidemiology - mortality
Abstract
While the risk for arterial vascular disease has been shown to be influenced by socioeconomic status (SES), there is limited information whether SES also influences the risk for venous thromboembolism (VTE). To evaluate whether there is an association between SES and VTE incidence. In 1990, all 730,050 inhabitants (379,465 women and 350,585 men) above 25 years of age in the County of Skåne in Sweden were evaluated with regard to age, household income, marital status, country of birth, number of years of residence in Sweden, educational level, and concomitant diseases. The cohort was hereafter prospectively investigated regarding diagnosis of, or death from VTE (deep venous thrombosis or pulmonary embolism ), during 1991-2003. The association between socioeconomic data and concomitant diseases at the baseline investigation 1990 and incidence of VTE during follow-up was examined by Cox proportional hazard models. During the 13 years prospective follow-up, 10,212 women and 7,922 men were diagnosed with VTE. In both genders, age above 40 years at baseline, low income, single status, and a lower level of education were associated with an increased risk of VTE. However, both men and women born outside of Sweden have a lower risk for VTE during follow-up, however. Age above 40 years, low income, single marital status, and lower level of education were independently related to an increased risk of VTE diagnosis during 13 years of prospective follow-up.
PubMed ID
23247894 View in PubMed
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