Subsequent arterial ischemic events in patients receiving anticoagulant therapy for venous thromboembolism

Following the demonstration that patients with deep venous thrombosis of the lower extremities have a significant higher prevalence of carotid plaques than matched control individuals, numerous studies have consistently shown that patients with venous thromboembolism -especially those with events of unknown origin -have a remarkably higher risk of developing subsequent arterial thrombotic events than control subjects. The two vascular disorders share several risk factors (including age, obesity, smoking habit, diabetes mellitus, hypertension, hypertriglyceridemia, and metabolic syndrome) and the abnormal elevation of markers of endothelial dysfunction (such as microalbuminuria and the plasma levels of soluble P-selectin and von Willebrand factor). These findings have potential implications for both research and medical practice. Patients with venous thromboembolism could be examined for asymptomatic atherosclerosis, in order to modify the risk profile in those with abnormal test results. Measures could include appropriate counseling about lifestyle changes, control of risk factors for atherosclerosis and the use of drugs, such as statin and aspirin, whose effectiveness in reducing the risk not only of arterial but also of venous thrombotic disorders has recently been shown.

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“…Becattini [40] Prandoni [41] Schulman [42] Bova [43] Young [44] Sørensen [45] Spencer [46] Klok [47] Barsoum [48] Madridano [49] Pasha [50] …”

Section: Refmentioning

confidence: 99%

Venous and Arterial Thrombosis: Is there a Link?

Prandoni

Milan

Vedovetto

et al. 2015

International Journal of Hematology Research

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“…A 2010 meta-analysis by Becattini et al that included 17 studies found an increased risk of arterial cardiovascular diseases in patients with unprovoked VTE compared to provoked VTE [52]. Madidrano et al examined the REITE registry composed of 12,397 PE patients and 10,973 DVT patients for development of subsequent ischemic events while on anticoagulation and found 45 patients with PE suffered ischemic stroke compared to 41 patients with DVT, with subsequent death in 13 and 6 patients, respectively [70].…”

Section: Ischemic Stroke Following Vtementioning

confidence: 99%

Neurological Complications of Pulmonary Embolism: a Literature Review

Desai

Krepostman

Collins

et al. 2021

Curr Neurol Neurosci Rep

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Purpose of ReviewThe present review discusses in-depth about neurological complications following acute venous thromboembolism (VTE). Recent Findings Intracranial hemorrhage, acute ischemic cerebrovascular events, and VTE in brain tumors are described as central nervous system (CNS) complications of PE, while peripheral neuropathy and neuropathic pain are reported as peripheral nervous system (PNS) sequelae of PE. Syncope and seizure are illustrated as atypical neurological presentations of PE. Summary Mounting evidence suggests higher risk of venous thromboembolism (VTE) in patients with neurological diseases, but data on reverse, i.e., neurological sequelae following VTE, is underexplored. The present review is an attempt to explore some of the latter issues categorized into CNS, PNS, and atypical complications following VTE.

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“…Median duration of anticoagulant therapy was reported only in 4 studies and ranged from 5.9 to 12 months. 22,27,32,33…”

Section: General Characteristic Of Selected Studiesmentioning

confidence: 99%

“…We screened 1,467 records of which 18 studies that evaluated risk factors of arterials events in patients with VTE were identified, including 9 prospective cohorts 13,21-28 and 9 retrospective cohorts 7,14,15,[29][30][31][32][33][34] (►Table 1). They were all published between 2005 and 2020.…”

Section: General Characteristic Of Selected Studiesmentioning

confidence: 99%

Risk Factors of Arterial Events in Patients with Venous Thromboembolism: A Systematic Review and Meta-Analysis

et al. 2021

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Background If recent studies suggested that arterial ischemic events in patients with venous thromboembolism (VTE) are more frequent than in the general population without VTE, whether patients with VTE have different risk factors of arterial events than classic known cardiovascular risk factors remain undefined. Through this systematic review and meta-analysis, we aimed to identify risk factors of arterial ischemic events in patients with VTE. Methods We searched PubMed, EMBASE, and Cochrane databases to identify cohort studies published between January 1, 2000, and December 31, 2020, reporting risk factors of arterials ischemic events in patients with VTE. Random-effect models meta-analysis served to get the pooled hazard ratio (HR) and 95% confidence interval (CI) of each risk factor identified. Results We screened 1,467 records of which 18 were finally included in systematic review and 10 in meta-analyses. Adjusted HR for 9 factors were included in meta-analysis. Male gender (HR: 1.38; 95% CI: 1.28–1.49), diabetes (HR: 1.65; 95% CI: 1.28–2.12), hypertension (HR: 1.38; 95% CI: 1.04–1.84), previous atherothrombotic event (HR: 3.22; 95% CI: 1.12–9.23), chronic kidney disease (HR: 1.41; 95% CI: 1.05–1.88), cancer (HR: 1.72; 95% CI: 1.41–2.09), and unprovoked VTE (HR: 1.88; 95% CI: 1.37–2.57) were the identified risk factors of arterial events in VTE population after meta-analysis. Conclusion Risk factors of arterial events in patients with VTE include usual cardiovascular risk factors and other risk factors that are related to VTE such as cancer and unprovoked VTE.

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Subsequent arterial ischemic events in patients receiving anticoagulant therapy for venous thromboembolism

Cited by 15 publications

References 18 publications

Venous and Arterial Thrombosis: Is there a Link?

Venous and Arterial Thrombosis: Is there a Link?

Neurological Complications of Pulmonary Embolism: a Literature Review

Risk Factors of Arterial Events in Patients with Venous Thromboembolism: A Systematic Review and Meta-Analysis

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