Risk of myocardial infarction and overall mortality in survivors of venous thromboembolism

Consuelo Huerta¹ , Saga Johansson²^,3 , Mari-Ann Wallander⁴ and Luis A García Rodríguez¹

¹Spanish Centre for Pharmacoepidemiologic Research (CEIFE), Madrid, Spain

²AstraZeneca R&D Mölndal, Sweden

³Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Sweden

⁴Department of Public Health and Caring Science, Uppsala University, Sweden

author email corresponding author email

Thrombosis Journal 2008, 6:10doi:10.1186/1477-9560-6-10


Published:	18 August 2008

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 follow-up 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.