Thromb Haemost 2022; 122(04): 590-599
DOI: 10.1055/s-0041-1732300
Stroke, Systemic or Venous Thromboembolism

Risk Factors of Arterial Events in Patients with Venous Thromboembolism: A Systematic Review and Meta-Analysis

1   Vascular Medicine Department, Brest Teaching Hospital, Brest University, Brest, France
2   EA3878 (GETBO), Groupe d'Etude de la Thrombose de Bretagne Occidentale, Brest University, Brest, France
,
Clément Hoffmann
1   Vascular Medicine Department, Brest Teaching Hospital, Brest University, Brest, France
2   EA3878 (GETBO), Groupe d'Etude de la Thrombose de Bretagne Occidentale, Brest University, Brest, France
,
Cécile Tromeur
2   EA3878 (GETBO), Groupe d'Etude de la Thrombose de Bretagne Occidentale, Brest University, Brest, France
3   Internal Medicine and Pneumology Department, Brest Teaching Hospital, Brest University, Brest, France
,
Romain Didier
3   Internal Medicine and Pneumology Department, Brest Teaching Hospital, Brest University, Brest, France
4   Cardiology Department, Brest Teaching Hospital, Brest University, Brest, France
,
Luc Bressollette
1   Vascular Medicine Department, Brest Teaching Hospital, Brest University, Brest, France
2   EA3878 (GETBO), Groupe d'Etude de la Thrombose de Bretagne Occidentale, Brest University, Brest, France
,
Karine Lacut
2   EA3878 (GETBO), Groupe d'Etude de la Thrombose de Bretagne Occidentale, Brest University, Brest, France
3   Internal Medicine and Pneumology Department, Brest Teaching Hospital, Brest University, Brest, France
,
Francis Couturaud
2   EA3878 (GETBO), Groupe d'Etude de la Thrombose de Bretagne Occidentale, Brest University, Brest, France
3   Internal Medicine and Pneumology Department, Brest Teaching Hospital, Brest University, Brest, France
› Author Affiliations
Funding The authors declare that they have not received any funding for this research.

Abstract

Background If recent studies suggested that arterial ischemic events in patients with venous thromboembolism (VTE) are more frequent than in the general population without VTE, whether patients with VTE have different risk factors of arterial events than classic known cardiovascular risk factors remain undefined. Through this systematic review and meta-analysis, we aimed to identify risk factors of arterial ischemic events in patients with VTE.

Methods We searched PubMed, EMBASE, and Cochrane databases to identify cohort studies published between January 1, 2000, and December 31, 2020, reporting risk factors of arterials ischemic events in patients with VTE. Random-effect models meta-analysis served to get the pooled hazard ratio (HR) and 95% confidence interval (CI) of each risk factor identified.

Results We screened 1,467 records of which 18 were finally included in systematic review and 10 in meta-analyses. Adjusted HR for 9 factors were included in meta-analysis. Male gender (HR: 1.38; 95% CI: 1.28–1.49), diabetes (HR: 1.65; 95% CI: 1.28–2.12), hypertension (HR: 1.38; 95% CI: 1.04–1.84), previous atherothrombotic event (HR: 3.22; 95% CI: 1.12–9.23), chronic kidney disease (HR: 1.41; 95% CI: 1.05–1.88), cancer (HR: 1.72; 95% CI: 1.41–2.09), and unprovoked VTE (HR: 1.88; 95% CI: 1.37–2.57) were the identified risk factors of arterial events in VTE population after meta-analysis.

Conclusion Risk factors of arterial events in patients with VTE include usual cardiovascular risk factors and other risk factors that are related to VTE such as cancer and unprovoked VTE.

Author Contributions

Conception, designing of the protocol: S.N., F.C., K.L., C.T. Literature search, studies selection, data extraction: S.N., C.H. Writing of the first draft: S.N. Data management, data synthesis and analysis: S.N. Critical revision: S.N., C.T., F.C., K.L., L.B. Final revision and approval of the final version: All authors. Guarantor of the review: S.N.


Supplementary Material



Publication History

Received: 07 April 2021

Accepted: 14 June 2021

Article published online:
11 July 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
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  • References

  • 1 Roth GA, Johnson C, Abajobir A. et al. Global, regional, and national burden of cardiovascular diseases for 10 causes, 1990 to 2015. J Am Coll Cardiol 2017; 70 (01) 1-25
  • 2 Virani SS, Alonso A, Benjamin EJ. et al; American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics-2020 update: a report from the American Heart Association. Circulation 2020; 141 (09) e139-e596
  • 3 Adelborg K, Sundbøll J, Sørensen HT. Arterial cardiovascular events and mortality following venous thromboembolism. Ann Transl Med 2015; 3 (09) 117
  • 4 Moheimani F, Jackson DE. Venous thromboembolism: classification, risk factors, diagnosis, and management. ISRN Hematol 2011; 2011: 124610
  • 5 Roth GA, Mensah GA, Johnson CO. et al; GBD-NHLBI-JACC Global Burden of Cardiovascular Diseases Writing Group. Global burden of cardiovascular diseases and risk factors, 1990-2019: update from the GBD 2019 study. J Am Coll Cardiol 2020; 76 (25) 2982-3021
  • 6 Majithia A, Bhatt DL. Novel antiplatelet therapies for atherothrombotic diseases. Arterioscler Thromb Vasc Biol 2019; 39 (04) 546-557
  • 7 Golemi I, Cote L, Iftikhar O. et al; Registro Informatizado de Enfermedad Tromboembólica Investigators. Incidence of major adverse cardiovascular events among patients with provoked and unprovoked venous thromboembolism: findings from the Registro Informatizado de Enfermedad Tromboembólica Registry. J Vasc Surg Venous Lymphat Disord 2020; 8 (03) 353-359
  • 8 Becattini C, Vedovati MC, Ageno W, Dentali F, Agnelli G. Incidence of arterial cardiovascular events after venous thromboembolism: a systematic review and a meta-analysis. J Thromb Haemost 2010; 8 (05) 891-897
  • 9 Rinde LB, Småbrekke B, Mathiesen EB. et al. Ischemic stroke and risk of venous thromboembolism in the general population: the Tromsø study. J Am Heart Assoc 2016; 5 (11) e004311
  • 10 Rinde LB, Lind C, Småbrekke B. et al. Impact of incident myocardial infarction on the risk of venous thromboembolism: the Tromsø Study. J Thromb Haemost 2016; 14 (06) 1183-1191
  • 11 Ageno W, Prandoni P, Romualdi E. et al. The metabolic syndrome and the risk of venous thrombosis: a case-control study. J Thromb Haemost 2006; 4 (09) 1914-1918
  • 12 Glynn RJ, Danielson E, Fonseca FAH. et al. A randomized trial of rosuvastatin in the prevention of venous thromboembolism. N Engl J Med 2009; 360 (18) 1851-1861
  • 13 Klok FA, Mos ICM, Broek L. et al. Risk of arterial cardiovascular events in patients after pulmonary embolism. Blood 2009; 114 (08) 1484-1488
  • 14 Laliberté F, Nutescu EA, Lefebvre P. et al. Risk factors associated with myocardial infarction in venous thromboembolism patients. Curr Med Res Opin 2014; 30 (01) 27-35
  • 15 Chang W-T, Chang C-L, Ho C-H, Hong C-S, Wang J-J, Chen Z-C. Long-term effects of unprovoked venous thromboembolism on mortality and major cardiovascular events. J Am Heart Assoc 2017; 6 (05) e005466
  • 16 Liberati A, Altman DG, Tetzlaff J. et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med 2009; 6 (07) e1000100
  • 17 Hartling L, Hamm M, Milne A. et al. Decision Rules for Application of the Newcastle-Ottawa Scale [Internet]. Validity and Inter-Rater Reliability Testing of Quality Assessment Instruments [Internet]. Agency for Healthcare Research and Quality (US);. 2012 Accessed January 21, 2021 at: https://www.ncbi.nlm.nih.gov/books/NBK92291/
  • 18 Cochran WG. The combination of estimates from different experiments. Biometrics 1954; 10 (01) 101-129
  • 19 Higgins JPT, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med 2002; 21 (11) 1539-1558
  • 20 Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997; 315 (7109): 629-634
  • 21 Le Moigne E, Timsit S, Ben Salem D. et al. Patent foramen ovale and ischemic stroke in patients with pulmonary embolism: a prospective cohort study. Ann Intern Med 2019; 170 (11) 756-763
  • 22 Vindiš D, Hutyra M, Šaňák D. et al. Patent foramen ovale and the risk of cerebral infarcts in acute pulmonary embolism-a prospective observational study. J Stroke Cerebrovasc Dis 2018; 27 (02) 357-364
  • 23 Ljungqvist M, Holmström M, Kieler H, Odeberg J, Lärfars G. Cardiovascular disease and mortality after a first episode of venous thromboembolism in young and middle-aged women. Thromb Res 2016; 138: 80-85
  • 24 Doyen D, Castellani M, Moceri P. et al. Patent foramen ovale and stroke in intermediate-risk pulmonary embolism. Chest 2014; 146 (04) 967-973
  • 25 Goliszek S, Wiśniewska M, Kurnicka K. et al. Patent foramen ovale increases the risk of acute ischemic stroke in patients with acute pulmonary embolism leading to right ventricular dysfunction. Thromb Res 2014; 134 (05) 1052-1056
  • 26 Becattini C, Agnelli G, Prandoni P. et al. A prospective study on cardiovascular events after acute pulmonary embolism. Eur Heart J 2005; 26 (01) 77-83
  • 27 Prandoni P, Ghirarduzzi A, Prins MH. et al. Venous thromboembolism and the risk of subsequent symptomatic atherosclerosis. J Thromb Haemost 2006; 4 (09) 1891-1896
  • 28 Barsoum MK, Cohoon KP, Roger VL. et al. Are myocardial infarction and venous thromboembolism associated? Population-based case-control and cohort studies. Thromb Res 2014; 134 (03) 593-598
  • 29 Hu W-S, Lin C-L. The predictive role of CHA2DS2-VASc score between venous thromboembolism and ischemic stroke: a large-scale cohort study. J Hypertens 2018; 36 (03) 628-633
  • 30 Bilora F, Ceresa M, Milan M, Sarolo L, Prandoni P. The impact of deep vein thrombosis on the risk of subsequent cardiovascular events: a 14-year follow-up study. Int Angiol 2017; 36 (02) 156-159
  • 31 Cannegieter SC, Horváth-Puhó E, Schmidt M. et al. Risk of venous and arterial thrombotic events in patients diagnosed with superficial vein thrombosis: a nationwide cohort study. Blood 2015; 125 (02) 229-235
  • 32 Madridano O, del Toro J, Lorenzo A. et al; RIETE Investigators. Subsequent arterial ischemic events in patients receiving anticoagulant therapy for venous thromboembolism. J Vasc Surg Venous Lymphat Disord 2015; 3 (02) 135-41.e1
  • 33 Lind C, Flinterman LE, Enga KF. et al. Impact of incident venous thromboembolism on risk of arterial thrombotic diseases. Circulation 2014; 129 (08) 855-863
  • 34 Spencer FA, Ginsberg JS, Chong A, Alter DA. The relationship between unprovoked venous thromboembolism, age, and acute myocardial infarction. J Thromb Haemost 2008; 6 (09) 1507-1513
  • 35 Gregson J, Kaptoge S, Bolton T. et al; Emerging Risk Factors Collaboration. Cardiovascular risk factors associated with venous thromboembolism. JAMA Cardiol 2019; 4 (02) 163-173
  • 36 Giza DE, Iliescu G, Hassan S, Marmagkiolis K, Iliescu C. Cancer as a risk factor for cardiovascular disease. Curr Oncol Rep 2017; 19 (06) 39
  • 37 McGale P, Darby SC, Hall P. et al. Incidence of heart disease in 35,000 women treated with radiotherapy for breast cancer in Denmark and Sweden. Radiother Oncol 2011; 100 (02) 167-175
  • 38 Chu C-N, Chen S-W, Bai L-Y, Mou C-H, Hsu CY, Sung F-C. Increase in stroke risk in patients with head and neck cancer: a retrospective cohort study. Br J Cancer 2011; 105 (09) 1419-1423
  • 39 Schmaier AA, Ambesh P, Campia U. Venous thromboembolism and cancer. Curr Cardiol Rep 2018; 20 (10) 89
  • 40 Kearon C, Akl EA, Ornelas J. et al. Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report. Chest 2016; 149 (02) 315-352
  • 41 Couturaud F, Sanchez O, Pernod G. et al; PADIS-PE Investigators. Six months vs extended oral anticoagulation after a first episode of pulmonary embolism: the PADIS-PE randomized clinical trial. JAMA 2015; 314 (01) 31-40
  • 42 Konstantinides SV, Meyer G, Becattini C. et al; The Task Force for the diagnosis and management of acute pulmonary embolism of the European Society of Cardiology (ESC). 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS): the Task Force for the diagnosis and management of acute pulmonary embolism of the European Society of Cardiology (ESC). Eur Respir J 2019; 54 (03) 1901647