Open AccessLong‐Term Effects of Unprovoked Venous Thromboembolism on Mortality and Major Cardiovascular Events
Author(s) -
Chang WeiTing,
Chang ChiaLi,
Ho ChungHan,
Hong ChonSeng,
Wang JhiJoung,
Chen ZhihCherng
Publication year - 2017
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.117.005466
Subject(s) - medicine , diabetes mellitus , cohort , incidence (geometry) , hyperlipidemia , adverse effect , etiology , cohort study , endocrinology , physics , optics
Background Patients with unprovoked venous thromboembolism ( VTE ) are at an increased risk of mortality, but whether their cardiovascular risks also increase remains to be determined. We aimed to investigate the factors associated with overall mortality and major adverse cardiovascular events in patients with unprovoked VTE . Methods and Results We identified 2154 patients newly diagnosed with unprovoked VTE from Taiwan's National Health Insurance Database between 2000 and 2013, excluding those with reversible etiologies, underlying cancer, or autoimmune diseases. These patients with VTE were compared with an age‐, sex‐, and cardiovascular risk‐matched cohort of 4308 controls. The risk of mortality and major adverse cardiovascular events in patients with VTE was 2.23 ( CI , 1.93–2.57; P <0.0001) and 1.86 ( CI , 1.65–2.09; P <0.0001) times, respectively, higher than that of the conditions in controls. These events mostly occurred during the first year after the diagnosis of unprovoked VTE . Among patients with VTE , advanced age, male sex, and comorbid diabetes mellitus indicated a higher incidence of mortality and major adverse cardiovascular events. Conversely, comorbid hyperlipidemia attenuated these risks. Conclusions This nation‐wide cohort study revealed that patients with unprovoked VTE , particularly older males with diabetes mellitus, had an elevated risk of both mortality and cardiovascular events. Risk of mortality and major adverse cardiovascular events were highest within the first year after diagnosis and persisted during the 10 years of follow‐up.