Myocardial Infarction as a Transient Risk Factor for Incident Venous Thromboembolism: Results from a Population-Based Case–Crossover Study

Joakim K. Sejrup; Trond Børvik; Gro Grimnes; Trond Isaksen; Kristian Hindberg; John-Bjarne Hansen; Vania M. Morelli; Sigrid K. Brækkan

doi:10.1055/s-0039-1692176

Thrombosis and Haemostasis, Inhaltsverzeichnis

Thromb Haemost 2019; 119(08): 1358-1364
DOI: 10.1055/s-0039-1692176

Stroke, Systemic or Venous Thromboembolism

Georg Thieme Verlag KG Stuttgart · New York

Myocardial Infarction as a Transient Risk Factor for Incident Venous Thromboembolism: Results from a Population-Based Case–Crossover Study

Joakim K. Sejrup

¹K.G. Jebsen-Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway

,

Trond Børvik

¹K.G. Jebsen-Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway

²Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway

,

Gro Grimnes

¹K.G. Jebsen-Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway

²Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway

,

Trond Isaksen

¹K.G. Jebsen-Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway

²Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway

,

Kristian Hindberg

¹K.G. Jebsen-Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway

²Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway

,

John-Bjarne Hansen

¹K.G. Jebsen-Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway

²Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway

,

Vania M. Morelli

¹K.G. Jebsen-Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway

,

Sigrid K. Brækkan

¹K.G. Jebsen-Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway

²Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway

› Institutsangaben

Abstract

Patients with myocardial infarction (MI) are at increased short-term risk of venous thromboembolism (VTE). The mechanisms behind this association are unclear. We aimed to investigate the impact of acute MI as a transient risk factor for incident VTE while taking other concomitant VTE risk factors into account. We conducted a case–crossover study of VTE patients (n = 707) recruited from the fourth survey of the Tromsø Study. VTE risk factors and hospitalizations were registered during the 90-day period preceding the VTE diagnosis (hazard period) and in four 90-day control periods. Conditional logistic regression was used to calculate odds ratios (ORs) with 95% confidence intervals (CIs) for VTE according to acute MI and after adjustment for other risk factors. Additionally, we applied a mediation analysis to quantify how much the known transient risk factors account for the observed effect of MI on VTE risk. MI was recorded in 13 (1.8%) of the hazard periods and in 6 (0.2%) of the control periods, which yielded a crude OR of 11.9 (95% CI: 3.9–36.7). Adjustment for immobilization and infection yielded an OR of 2.7 (95% CI: 0.6–11.2). The OR was attenuated to 2.6 (95% CI: 0.6–11.9) after further adjustment for major surgery, trauma, red blood cell transfusion, and central venous catheterization. Approximately 60% of the association between MI and VTE was mediated through infection and immobilization. In conclusion, our findings suggest that the increased VTE risk after MI may to a large extent be explained by concomitant conditions related to MI, particularly infections and immobilization.

Keywords

venous thromboembolism - myocardial infarction - transient risk factor - infection - immobilization

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Referenzen

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