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Adverse Events and All-Cause Mortality in Danish Patients with Cerebral Venous Thrombosis: A Nationwide Cohort StudyFunding This study was supported by the Obel Family Foundation. The funding source played no role in in study design; the collection, analysis, or interpretation of data; writing the report; or in the decision to submit the article for publication.
Background Cerebral venous thrombosis (CVT) is a rare manifestation of stroke and venous thromboembolism (VTE), compared with deep vein thrombosis (DVT) and pulmonary embolism (PE). We examined whether CVT was associated with adverse cardiovascular events.
Methods A Danish cohort study with adult patients diagnosed with CVT (N = 1,015) between 1997 and 2017. We matched 10 patients with VTE (DVT and PE) to each patient with CVT for age, sex, and diagnosis year. We also matched 10 individuals from the general population to each patient with CVT. We computed cumulative incidence and estimated hazard ratios (HRs) with 95% confidence intervals (95% CIs) at 5 years for major bleeding, intracranial bleeding, ischemic stroke, and cardiovascular events. Death was examined separately.
Results Major bleeding risks were 1.2% for CVT and 0.7% for VTE at 6 months; these risks increased to 2.7% and 2.6%, respectively, at 5 years. Although rare, intracranial bleeding risks were markedly higher for CVT (2.9%) than for VTE (0.4%) at 5 years (HR = 8.9, 95% CI: 5.3–15.1). Incidences of ischemic stroke were 5.9% for CVT and 0.3% for VTE, at 6 months; and 10.0% and 1.4%, respectively, at 5 years (HR = 9.5, 95% CI: 7.1–12.7). In contrast, incidence of cardiac events was lower for CVT that VTE (1.7% vs. 3.6% at 5 years). Mortality risk was higher after CVT compared with VTE, at 6 months (6.6% vs. 3.8%), but the risks differed little at 5 years (14.3% vs. 14.1%).
Conclusion Intracranial bleeding, ischemic stroke, and mortality risks were higher for patients with CVT than matched patients with VTE and the general population, particularly within 6 months after diagnosis.
A.G.O.: Conceptualization, methodology, investigation, formal analysis, writing the original draft preparation, reviewing and editing the manuscript, and project administration. F.S.: Conceptualization, methodology, investigation, data curation, resources, formal analysis, software, validation, visualization, writing the original draft preparation, and reviewing and editing the manuscript. S.D.A.: Conceptualization, reviewing, and editing the manuscript. T.B.L.: Conceptualization, methodology, investigation, supervision, funding acquisition, resources, writing the original draft preparation, and reviewing and editing the manuscript.
Data Sharing Statement
Our approvals for using the data sources for the current study did not allow us to distribute or make patient data directly available to other parties. Interested researchers may apply for data access through the Research Service at the Danish Health Data Authority (e-mail: email@example.com; phone: +45 3268 5116). Up-to-date information on data access is available online (http://sundhedsdatastyrelsen.dk/da/forskerservice). Access to data from the Danish Health Data Authority requires approval from the Danish Data Protection Agency (https://www.datatilsynet.dk/english/the-danish-data-protection-agency/introduction-to-the-danish-data-protection-agency/).
Received: 28 May 2021
Accepted: 18 January 2022
Article published online:
10 June 2022
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