Incidence of arterial cardiovascular events in patients with idiopathic venous thromboembolism
Incidence of arterial cardiovascular events in patients with idiopathic venous thromboembolism
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特发性静脉血栓栓塞患者动脉心血管事件的发生率
DOI：
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发表时间：
2006
影响因子：
6.7
通讯作者：
P. Prandoni
中科院分区：
文献类型：
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作者：
C. Bova;A. Marchiori;A. Noto;V. Rossi;F. Daniele;C. Santoro;Roberto Ricchio;R. De Lorenzo;Rossella Umbaca;P. Prandoni
摘要 最近的数据显示，不明原因静脉血栓栓塞 (VTE) 患者的动脉事件发生率高于继发性疾病患者。特发性 VTE 患者发生后续动脉事件的风险是否比一般人群更高尚不清楚。目的是评估特发性 VTE 患者和对照受试者随后发生动脉事件的发生率。在一项回顾性队列研究中，我们比较了 151 名客观确诊的自发性 VTE 连续患者和从两名家庭医生数据库中随机选择的 151 名对照受试者的后续动脉事件（即急性心肌梗塞、缺血性中风和外周动脉疾病）的发生率。我们收集了 VTE 发作时或对照日期的心血管危险因素（高血压、高胆固醇血症、糖尿病、肥胖和吸烟）的信息，并考虑了从此时起的随访。在索引日期之前患有动脉事件的患者和对照被排除在外。在平均 43.1 (± 21.7) 个月的随访期间，VTE 患者发生了 16 起动脉事件，对照组发生了 6 起动脉事件（HR，2.84；95% CI，1.11 至 7.27；p = 0.03）。调整年龄和其他心血管危险因素后，差异仍然显着（HR 2.86；95% CI，1.07 至 1.07）。 7.62)。VTE 患者的总体死亡率也较高（12 例死亡对 4 例死亡）。总之，动脉事件在既往特发性 VTE 患者中比一般人群更常见。这些发现可能具有实际意义。
Summary Recent data have showna higher incidence of arterial events in patients with venous thromboembolism (VTE) of unknown origin than in those with the secondary form of disease. Whether patients with idiopathic VTE have a higher risk of subsequent arterial events than the general population is unknown. The aim was to evaluate the rates of subsequent arterial events in patients with idiopathic VTE and control subjects. In a retrospective cohort study we compared the rates of subsequent arterial events (i.e. acute myocardial infarction, ischemic stroke and peripheral arterial disease) in 151 consecutive patients with objectively confirmed spontaneousVTE and 151 control subjects randomly selected from the database of two family physicians. We collected information about cardiovascular risk-factors (hypertension, hypercholesterolemia, diabetes, obesity and smoke) at the time of VTE episode, or corresponding date for the controls, and considered the follow-up from this time. Patients and controls who had suffered from arterial events before the index date were excluded. During a mean follow-up of 43.1 (± 21.7) months there were 16 arterial events in theVTE patients and six in the control group (HR, 2.84; 95% CI, 1.11 to 7.27; p= 0.03).The difference remained significant after adjusting for age and other cardiovascular risk factors (HR 2.86; 95% CI, 1.07 to 7.62).Overall mortality was also higher in theVTE patients (12 vs.4 deaths). In conclusion, arterial events are more common in patients with previous idiopathic VTE than in the general population. These findings may have practical implications.