Long-term survival of patients with a history of venous thromboembolism

Reitter, S.; Waldhoer, Thomas; Mayerhofer, Michaela; Eigenbauer, Ernst; Ay, Cihan; Kyrle, Paul A.; Pabinger, Ingrid

doi:10.1007/s00277-011-1160-0

Cited by 14 publications

(13 citation statements)

References 22 publications

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“…8,[24][25][26][27] We confirmed that cancer and cardiovascular diseases were frequent causes of death, 2,3,8 but more important, we also found that VTE and pneumonia were important causes of death among the patients in the VTE cohort. This long-term increased VTE-related death rate among patients diagnosed with VTE has not been reported before.…”

Section: Discussionsupporting

confidence: 64%

“…12 The latter finding of unaltered long-term survival was supported by a recent cohort study comparing mortality among patients with VTE and population control subjects. 3 The follow-up period started 3 months after a first or subsequent VTE, and cancer patients were excluded from the study. 3 Similarly, a cohort study of VTE patients did not find an elevated standardized mortality rate among patients surviving cessation of oral anticoagulant treatment.…”

Section: Discussionmentioning

confidence: 99%

“…3 The follow-up period started 3 months after a first or subsequent VTE, and cancer patients were excluded from the study. 3 Similarly, a cohort study of VTE patients did not find an elevated standardized mortality rate among patients surviving cessation of oral anticoagulant treatment. 22 Finally, a population-based cohort study of 1567 patients with firsttime VTE indicated a 10% decline in 3-year mortality in patients diagnosed in 2003 compared with 1999 (mortality risk, 0.90; 95% CI, 0.74-1.10).…”

Section: Discussionmentioning

confidence: 99%

“…1,8,12 Only a few studies have compared long-term mortality between VTE patients and a comparison cohort from the general population, with inconsistent results. 1,3,8,12 The reported risk varied between a null association, 3 a 40% higher mortality in VTE patients after 10 years compared with expected mortality in the general population, 8 a higher mortality only among patients with cancer, 12 and higher mortality for both cancer patients and noncancer patients. …”

mentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8][9] A recent study reported an 8-year mortality risk of 12%, 1 whereas in an earlier study, mortality risk reached 50% after 8 years of follow-up. 5 Previous studies were limited by short follow-up time (maximum, 10 years), [1][2][3][4][6][7][8][9][10][11] age restrictions (<70 years of age 1 or between 65 and 89 years of age 7 ), lack of adjustment for comorbidity 3,12 or calendar period, 3,5 and failure to examine mortality for DVT and PE separately. 1,8,12 Only a few studies have compared long-term mortality between VTE patients and a comparison cohort from the general population, with inconsistent results.…”

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confidence: 99%

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30-Year Mortality After Venous Thromboembolism

et al. 2014

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This cohort study drew on the entire Danish population, with 7 046 778 residents alive between 1980 and 2011. Data were obtained from the Danish National Registry of Patients, which Background-Studies on long-term mortality after venous thromboembolism (VTE) are sparse. Methods and Results-Using Danish medical databases, we conducted a 30-year nationwide population-based cohort study of 128 223 patients with first-time VTE 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 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. Conclusions-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.

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Section: Discussionsupporting

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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30-Year Mortality After Venous Thromboembolism

et al. 2014

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Family history of venous thromboembolism and mortality after venous thromboembolism: a Swedish population-based cohort study

Zöller

Pirouzifard

Sundquist

et al. 2016

J Thromb Thrombolysis

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Studies on whether family history (FH) of venous thromboembolism (VTE) affects long-term mortality after VTE are missing. The aim of this study was to determine whether FH of VTE affects long-term mortality after a first episode of VTE. Using Swedish medical databases, we conducted a 30-year nationwide cohort study of 49,159 adult Swedish born patients included in the multi-generation register (born 1932 or later) with a first-time VTE (1981–2010). Using Cox regression, we assessed mortality Hazard ratios (HRs) with 95% confidence intervals (CIs). Totally 10,093 (20.5%) patients with VTE had a first-degree FH of VTE (parent/sibling). Patients without FH of VTE had significantly more VTE provoking risk factors and comorbidities than those with FH. The mortality HR the first 10-years after first time VTE was decreased for those with FH of VTE compared to for those without FH: crude HR 0.807, 95% CI 0.771–0.845 and adjusted HR 0.864, 95% CI 0.826–0.905. After 10-years of follow-up there was no significant effect of FH of VTE on mortality: crude HR = 1.018, 95% CI 0.905–1.145 and adjusted HR = 0.995, 95% CI 0.884–1.119. Cancer-associated mortality was more common in those without FH the first 10 years (56.9 vs. 53.4%, p = 0.002). After 10 years there were no difference in cancer-associated mortality (4.9 vs. 5.6%, p = 0.604). The results suggest that patients with FH of VTE have lower thrombotic threshold and need less provoking factors and comorbidities. They have also slightly lower total and cancer mortality the first 10 years after VTE.Electronic supplementary materialThe online version of this article (doi:10.1007/s11239-016-1464-y) contains supplementary material, which is available to authorized users.

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