Comorbidity and risk of venous thromboembolism after hospitalization for first‐time myocardial infarction: A population‐based cohort study

ObjectivesTo assess the risks of myocardial infarction, stroke, peripheral artery disease, venous thromboembolism, atrial fibrillation or atrial flutter and heart failure in patients with constipation compared with a general population cohort.DesignPopulation-based matched cohort study.SettingAll Danish hospitals and hospital outpatient clinics from 2004 to 2013.ParticipantsPatients with a constipation diagnosis matched on age, sex and calendar year to 10 individuals without constipation from the general population.Main outcomes measuresComorbidity-adjusted and medication-adjusted hazard ratios (aHRs) for cardiovascular outcomes based on Cox regression analysis.Results83 239 patients with constipation were matched to 832 384 individuals without constipation. The median age at constipation diagnosis was 46.5% and 41% were men. Constipation was strongly associated with venous thromboembolism (aHR 2.04, 95% CI 1.89 to 2.20), especially splanchnic venous thrombosis (4.23, 95% CI 2.45 to 7.31). Constipation was also associated with arterial events, including myocardial infarction (1.24, 95% CI 1.14 to 1.35), ischaemic stroke (1.50, 95% CI 1.41 to 1.60), haemorrhagic stroke (1.46, 95% CI 1.26 to 1.69), peripheral artery disease (1.34, 95% CI 1.20 to 1.50), atrial fibrillation or atrial flutter (1.27, 95% CI 1.20 to 1.34) and heart failure (1.52, 95% CI 1.42 to 1.62). The associations were strongest during the first year after the constipation diagnosis and strengthened with an increased number of laxative prescriptions.ConclusionsConstipation was associated with an increased risk of several cardiovascular diseases, in particular venous thromboembolism.

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P5012Ten-year trends and outcomes in cardiogenic shock related to first-time acute myocardial infarction: a nationwide population-based cohort study

European Heart Journal ◽

10.1093/eurheartj/ehz746.0190 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

M Dam Lauridsen ◽

R Rorth ◽

M G Lindholm ◽

J Kjaergaard ◽

M Schmidt ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Cohort Study ◽

Cardiogenic Shock ◽

Large Population ◽

Multivariable Analysis ◽

Population Based ◽

Cox Regression Analysis ◽

Incidence And Mortality ◽

First Time

Abstract Introduction Despite declining incidence and mortality for acute myocardial infarction, cardiogenic shock remains a severe complication with poor in-hospital prognosis. Little is known about the temporal trends in hospitalization with acute myocardial infarction-related cardiogenic shock (AMI-CS) and the long-term prognosis. Purpose We aimed to investigate the hospitalization with first-time AMI-CS and subsequent 1-year mortality. Methods In this nationwide Danish cohort study we identified from 2005 through 2015 patients with first-time acute myocardial infarction and compared those with and without cardiogenic shock (defined by either an ICD-10 diagnosis code with cardiogenic shock and/or procedure code with inotropes or vasopressors). Patient characteristics and 1-year mortality were compared between groups using Kaplan-Meier plots and multivariable Cox regression analysis. Results We included 96,030 patients with acute myocardial infarction of whom 5.4% had cardiogenic shock. Median age was 69.7 years (IQR 59.0–80.1) and 37.5% were female among those without cardiogenic shock and 70.2 years (IQR 61.4–78.1) and 33.0% were female in those with cardiogenic shock. We observed no change in hospitalization with cardiogenic shock during the study period (5.45% in 2006 vs 5.54% for 2016, P for difference 0.6). One-year mortality was higher among those with cardiogenic shock relative those without (See Figure). Crude 1-year mortality risk associated with AMI decreased over time from 23.4% in 2006 vs 11.5% in 2016 (p for difference <0.0001) and this was consistent for AMI patients without CS (21.4% in 2006 vs 9.4% in 2016, p<0.0001) and patients with AMI-CS (58.1% in 2006 vs 46.2% in 2016, p<0.0001). When comparing patients with AMI-CS to those without in multivariable analysis, AMI-CS was associated with a 1-year mortality hazard ratio of 5.38 (95% CI 5.17–6.61)). Cumulative 1-year mortality among patien Conclusion In a large population-based setting, this study suggests that the hospitalization for first-time AMI-CS was stable from 2005 through 2015, while mortality improved with time. However, the grave outcome related to AMI-CS remains with a 5-times higher mortality compared to AMI patients without CS. Acknowledgement/Funding Rigshospitalets Research Fund

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Excess Risk of Cancer in Patients With Primary Venous Thromboembolism: A National, Population-based Cohort Study

Yearbook of Vascular Surgery ◽

10.1016/s0749-4041(08)70275-6 ◽

2006 ◽

Vol 2006 ◽

pp. 358-359

Author(s):

G.L. Moneta

Keyword(s):

Cohort Study ◽

Venous Thromboembolism ◽

Population Based ◽

Excess Risk ◽

National Population ◽

Risk Of Cancer

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Faculty Opinions recommendation of Hospitalisation for venous thromboembolism in cancer patients and the general population: a population-based cohort study in Denmark, 1997-2006.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.5232956.5173054 ◽

2010 ◽

Author(s):

Chris Forsmark ◽

Dennis Collins

Keyword(s):

Cohort Study ◽

Venous Thromboembolism ◽

General Population ◽

Cancer Patients ◽

Population Based

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Cardiovascular Outcomes of Sitagliptin in Type 2 Diabetic Patients with Acute Myocardial Infarction, a Population-Based Cohort Study in Taiwan

PLoS ONE ◽

10.1371/journal.pone.0131122 ◽

2015 ◽

Vol 10 (6) ◽

pp. e0131122 ◽

Cited By ~ 15

Author(s):

Szu-Heng Wang ◽

Dong-Yi Chen ◽

Yu-Sheng Lin ◽

Chun-Tai Mao ◽

Ming-Lung Tsai ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Cohort Study ◽

Population Based ◽

Cardiovascular Outcomes ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Type 2 Diabetic

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Risk of arterial thromboembolism, venous thromboembolism, and bleeding in patients with nephrotic syndrome: A population-based cohort study

The American Journal of Medicine ◽

10.1016/j.amjmed.2021.11.018 ◽

2021 ◽

Author(s):

Søren Viborg Vestergaard ◽

Henrik Birn ◽

Bianka Darvalics ◽

Dorothea Nitsch ◽

Henrik Toft Sørensen ◽

...

Keyword(s):

Nephrotic Syndrome ◽

Cohort Study ◽

Venous Thromboembolism ◽

Population Based ◽

Arterial Thromboembolism

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Epidemiology of first and recurrent venous thromboembolism: A population-based cohort study in patients without active cancer

Thrombosis and Haemostasis ◽

10.1160/th13-09-0793 ◽

2014 ◽

Vol 112 (08) ◽

pp. 255-263 ◽

Cited By ~ 80

Author(s):

Alexander T. Cohen ◽

Luke Bamber ◽

Stephan Rietbrock ◽

Carlos Martinez

Keyword(s):

Cohort Study ◽

Venous Thromboembolism ◽

The Elderly ◽

Population Based ◽

Incidence Rates ◽

Practice Research ◽

Clinical Practice Research Datalink ◽

Recurrence Rates ◽

Recurrent Vte ◽

Active Cancer

SummaryContemporary data from population studies on the incidence and complications of venous thromboembolism (VTE) are limited. An observational cohort study was undertaken to estimate the incidence of first and recurrent VTE. The cohort was identified from all patients in the UK Clinical Practice Research Datalink (CPRD) with additional linked information on hospitalisation and cause of death. Between 2001 and 2011, patients with first VTE were identified and the subset without active cancer-related VTE observed for up to 10 years for recurrent VTE. The 10-year cumulative incidence rates (CIR) were derived with adjustment for mortality as a competing risk event. A total of 35,373 first VTE events (12,073 provoked, 16,708 unprovoked and 6592 active cancer-associated VTE) among 26.9 million person-years of observation were identified. The overall incidence rate (IR) of VTE was 131.5 (95% CI, 130.2–132.9) per 100,000 person-years and 107.0 (95% CI, 105.8–108.2) after excluding cancer-associated VTE. DVT was more common in the young and PE was more common in the elderly. VTE recurrence occurred in 3671 (CIR 25.2%). The IR for recurrence peaked in the first six months at around 11 per 100 person years. It levelled out after three years and then remained at around 2 per 100 person years from year 4–10 of follow-up. The IRs for recurrences were particularly high in young men. In conclusion, VTE is common and associated with high recurrence rates. Effort is required to prevent VTE and to reduce recurrences.

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