Impact of incident myocardial infarction on the risk of venous thromboembolism: the Tromsø Study
AuthorBalteskard Rinde, Ludvig; Lind, Caroline; Småbrekke, Birgit; Njølstad, Inger; Mathiesen, Ellisiv B.; Wilsgaard, Tom; Løchen, Maja-Lisa; Mathiesen Hald, Erin; Vik, Anders; Brækkan, Sigrid Kufaas; Hansen, John-Bjarne; Rinde, Ludvig Balteskard
Objectives: We aimed to study the association between incident myocardial infarction (MI) and VTE in a prospective population-based cohort.
Methods: Study participants (n=29 506) were recruited from three surveys of the Tromsø Study (conducted in 1994-95, 2001-02 and 2007-08) and followed through 2010. All incident events of MI and VTE during follow-up were recorded. Cox-regression models with age as time scale and MI as a time-dependent variable were used to calculate hazard ratios (HR) of VTE adjusted for sex, BMI, blood pressure, diabetes mellitus, HDL-cholesterol, smoking, physical activity and education level.
Results: During a median follow-up of 15.7 years, 1 853 participants experienced a MI and 699 experienced a VTE. MI was associated with a 51% increased risk of VTE (HR 1.51; 95% CI 1.08-2.10) and a 72% increased risk of pulmonary embolism (PE) (HR 1.72; 95% CI 1.07-2.75), but not significantly associated with risk of deep vein thrombosis (DVT) (HR 1.36, 95% CI, 0.86-2.15). The highest risk estimates for PE were observed during the first sixth months after the MI (HR 8.49; 95% CI 4.00-18.77). MI explained 6.2% of the PEs in the population (population attributable risk) and 78.5% of the PE risk in MI-patients (attributable risk).
Conclusions: Our findings indicate that MI is associated with a transient increased risk of VTE independent of traditional atherosclerotic risk factors. The risk estimates were particularly high for PE.
CitationRinde LB, Lind C, Småbrekke B, Njølstad I, Mathiesen EB, Wilsgaard T, Løchen M-L, Hald EM, Vik A, Brækkan SK, Hansen J-B. Impact of incident myocardial infarction on the risk of venous thromboembolism: the Tromsø Study. J Thromb Haemost 2016; 14: 1183–91.
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