Thromb Haemost 2022; 122(09): 1524-1531
DOI: 10.1055/s-0042-1743473
Stroke, Systemic or Venous Thromboembolism

Adverse Events and All-Cause Mortality in Danish Patients with Cerebral Venous Thrombosis: A Nationwide Cohort Study

Anne Gulbech Ording
1   Unit for Thrombosis and Drug Research, Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
,
Flemming Skjøth
1   Unit for Thrombosis and Drug Research, Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
2   Unit for Clinical Biostatistics, Aalborg University Hospital, Aalborg, Denmark
,
Søren Due Andersen
3   Department of Neurology, Aalborg University Hospital, Aalborg, Denmark
,
Torben Bjerregaard Larsen
1   Unit for Thrombosis and Drug Research, Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
› Author Affiliations
Funding 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.

Abstract

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.

Author Contributions

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: forskerservice@sundhedsdata.dk; 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/).


Supplementary Material



Publication History

Received: 28 May 2021

Accepted: 18 January 2022

Article published online:
10 June 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany