nach oben

Erschienen in:

21.08.2018 | Original Paper

Sex differences in risk of incident venous thromboembolism in heart failure patients

verfasst von: Line Melgaard, Peter Brønnum Nielsen, Thure Filskov Overvad, Flemming Skjøth, Gregory Y. H. Lip, Torben Bjerregaard Larsen

Erschienen in: Clinical Research in Cardiology | Ausgabe 1/2019

Einloggen, um Zugang zu erhalten

Abstract

Background

In patients with incident heart failure, the risk of venous thromboembolism (VTE), defined as pulmonary embolism (PE) and/or deep venous thrombosis (DVT), is sparsely described, especially potential sex differences. We conducted an observational study to evaluate risk of VTE among male and female heart failure patients.

Methods

Population-based cohort study of patients diagnosed with incident heart failure during 2000–2015, identified by record linkage between nationwide registries in Denmark. Using a pseudo-value approach, we calculated relative risks [RR] of VTE at 1 and 3 years of follow-up. Crude VTE risk for males and females are reported and contrasted after adjustment for established clinical risk factors for VTE.

Results

A total of 32,330 heart failure patients were included, of which 15,238 (47%) were females. For the combined endpoint of VTE, female sex was associated with a higher risk (1-year adjusted RR: 1.30, 95% confidence interval [CI]: 0.97–1.73; 3-year adjusted RR: 1.34, 95% CI: 1.07–1.67) compared to male patients. For the individual endpoints of PE and DVT after 1-year of follow-up, female sex was only associated with a higher risk of PE and not DVT, compared to male patients. However, female sex was associated with a higher risk of both PE and DVT after 3 years of follow-up.

Conclusions

Among incident heart failure patients, female sex is associated with a higher risk of VTE, mainly driven by an excess risk of PE. This finding may help improve clinical decision-making regarding VTE prophylaxis in patients with heart failure.

Nur mit Berechtigung zugänglich

Haeusler KG, Laufs U, Endres M (2011) Chronic heart failure and ischemic stroke. Stroke 42:2977–2982CrossRefPubMed

Shantsila E, Lip GYH (2014) Thrombotic complications in heart failure: an underappreciated challenge. Circulation 130:387–389CrossRefPubMed

Patel K, Fasanya A, Yadam S, Joshi AA, Singh AC, DuMont T (2017) Pathogenesis and epidemiology of venous thromboembolic disease. Crit Care Nurs Q 40:191–200CrossRefPubMed

Edelsberg J, Hagiwara M, Taneja C, Oster G (2006) Risk of venous thromboembolism among hospitalized medically ill patients. Am J Heal Pharm 63:S16–S22CrossRef

Spyropoulos AC, Hussein M, Lin J, Battleman D (2009) Rates of venous thromboembolism occurrence in medical patients among the insured population. Thromb Haemost 102:951–957CrossRefPubMed

Geerts WH, Bergqvist D, Pineo GF, Heit JA, Samama CM, Lassen MR et al. (2008) Prevention of venous thromboembolism: American College of chest physicians evidence-based clinical practice guidelines (8th edn). Chest 133:381S–453SCrossRefPubMed

Lindenfeld J, Albert NM, Boehmer JP, Collins SP, Ezekowitz JA, Givertz MM et al (2010) HFSA 2010 comprehensive heart failure practice guideline. J Card Fail 16:e1–e194CrossRefPubMed

Mebazaa A, Spiro TE, Büller HR, Haskell L, Hu D, Hull R et al (2014) Predicting the risk of venous thromboembolism in patients hospitalized with heart failure. Circulation 130:410–418CrossRefPubMed

Dries D, Rosenberg Y, Waclawiw M, Domanski M (1997) Ejection fraction and risk of thromboembolic events in patients with systolic dysfunction and sinus rhythm: evidence for gender differences in the studies of left ventricular dysfunction trials. J Am Coll Cardiol 29:1074–1080CrossRefPubMed

10.

Beemath A, Stein PD, Skaf E, Al Sibae MR, Alesh I (2006) Risk of venous thromboembolism in patients hospitalized with heart failure. Am J Cardiol 98:793–795CrossRefPubMed

11.

Silverstein MD, Heit JA, Mohr DN, Petterson TM, O’Fallon WM, Melton LJ (1998) Trends in the incidence of deep vein thrombosis and pulmonary embolism: a 25-year population-based study. Arch Intern Med 158:585–593CrossRefPubMed

12.

Bauersachs RM, Riess H, Hach-Wunderle V, Gerlach H, Carnarius H, Eberle S et al (2010) Impact of gender on the clinical presentation and diagnosis of deep-vein thrombosis. Thromb Haemost 103:710–717CrossRefPubMed

13.

Roseann Andreou E, Koru-Sengul T, Linkins L, Bates SM, Ginsberg JS, Kearon C (2008) Differences in clinical presentation of deep vein thrombosis in men and women. J Thromb Haemost 6:1713–1719CrossRefPubMed

14.

Pedersen CB (2011) The danish civil registration system. Scand J Public Health 39(7 Suppl):22–25CrossRefPubMed

15.

Lynge E, Sandegaard JL, Rebolj M (2011) The Danish National Patient Register. Scand J Public Health 39(7 Suppl):30–33CrossRefPubMed

16.

Kildemoes HW, Sørensen HT, Hallas J (2011) The Danish National Prescription Registry. Scand J Public Health 39(7 Suppl):38–41CrossRefPubMed

17.

Kümler T, Gislason GH, Kirk V, Bay M, Nielsen OW, Køber L et al (2008) Accuracy of a heart failure diagnosis in administrative registers. Eur J Heart Fail 10:658–660CrossRefPubMed

18.

Thygesen SK, Christiansen CF, Christensen S, Lash TL, Sørensen HT (2011) The predictive value of ICD-10 diagnostic coding used to assess Charlson comorbidity index conditions in the population-based Danish National Registry of Patients. BMC Med Res Methodol 11:83CrossRefPubMedPubMedCentral

19.

Sundbøll J, Adelborg K, Munch T, Frøslev T, Toft Sørensen H, Erik Bøtker H et al. (2016) Positive predictive value of cardiovascular diagnoses in the Danish National Patient Registry: a validation study. BMJ Open 6:e012832CrossRefPubMedPubMedCentral

20.

Schmidt M, Cannegieter SC, Johannesdottir SA, Dekkers OM, Horváth-Puhó E, Sørensen HT (2014) Statin use and venous thromboembolism recurrence: a combined nationwide cohort and nested case-control study. J Thromb Haemost 12:1207–1215CrossRefPubMed

21.

Delekta J, Hansen SM, AlZuhairi KS, Bork CS, Joensen AM (2018) The validity of the diagnosis of heart failure (I50.0–I50.9) in the Danish National Patient Register. Dan Med J 65:2–6

22.

Zöller B, Ji J, Sundquist J, Sundquist K (2012) Risk of haemorrhagic and ischaemic stroke in patients with cancer: a nationwide follow-up study from Sweden. Eur J Cancer 48:1875–1883CrossRefPubMed

23.

Severinsen MT, Kristensen SR, Overvad K, Dethlefsen C, Tjønneland A, Johnsen SP (2010) Venous thromboembolism discharge diagnoses in the Danish National Patient Registry should be used with caution. J Clin Epidemiol 63:223–228CrossRefPubMed

24.

Gooley T, Leisenring W, Crowley J, Storer B (1999) Estimation of failure probabilities in the presence of competing risks: new representations of old estimators. Stat Med 18:695–706CrossRefPubMed

25.

Konstantinides SV, Torbicki A, Agnelli G, Danchin N, Fitzmaurice D, Galiè N et al (2014) 2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism. Eur Heart J 35:3033–3080CrossRefPubMed

26.

Mahmoodi BK, Cushman M, Næss IA, Allison MA, Bos WJ, Brækkan SK et al (2017) Association of traditional cardiovascular risk factors with venous thromboembolism. Circulation 135:7–16CrossRefPubMed

27.

Cole SR, Hernán MA (2004) Adjusted survival curves with inverse probability weights. Comput Methods Programs Biomed 75:45–49CrossRefPubMed

28.

Klein J, Andersen P (2005) Regression modeling of competing risks data based on pseudovalues of the cumulative incidence function. Biometrics 61:223–229CrossRefPubMed

29.

Klein J, Logan B, Harhoff M, Andersen P (2007) Analyzing survival curves at a fixed point in time. Stat Med 26:4505–4519CrossRefPubMed

30.

Glynn RJ, Schneeweiss S, Stürmer T (2006) Indications for propensity scores and review of their use in pharmacoepidemiology. Basic Clin Pharmacol Toxicol 98:253–259CrossRefPubMedPubMedCentral

31.

Haskins IN, Amdur R, Sarani B, Vaziri K (2015) Congestive heart failure is a risk factor for venous thromboembolism in bariatric surgery. Surg Obes Relat Dis 11:1140–1145CrossRefPubMed

32.

Severinsen MT, Johnsen SP, Tjønneland A, Overvad K, Dethlefsen C, Kristensen SR (2010) Body height and sex-related differences in incidence of venous thromboembolism: a Danish follow-up study. Eur J Intern Med 21:268–272CrossRefPubMed

33.

Dean SM, Abraham W (2010) Venous thromboembolic disease in congestive heart failure. Congest Hear Fail 16:164–169CrossRef

34.

Howell MD, Geraci JM, Knowlton AA (2001) Congestive heart failure and outpatient risk of venous thromboembolism: a retrospective, case-control study. J Clin Epidemiol 54:810–816CrossRefPubMed

35.

Rothberg MB, Lindenauer PK, Lahti M, Pekow PS, Selker HP (2011) Risk factor model to predict venous thromboembolism in hospitalized medical patients. J Hosp Med 6:202–209CrossRefPubMed

36.

Stein PD, Hull RD, Kayali F, Ghali WA, Alshab AK, Olson RE (2004) Venous thromboembolism according to age: the impact of an aging population. Arch Intern Med 164:2260–2265CrossRefPubMed

37.

Heit JA, Kobbervig CE, James AH, Petterson TM, Bailey KR, Melton LJ (2005) Trends in the incidence of venous thromboembolism during pregnancy or postpartum: a 30-year population-based study. Ann Intern Med 143:697–706CrossRefPubMed

38.

Gomes MPV, Deitcher SR (2004) Risk of venous thromboembolic disease associated with hormonal contraceptives and hormone replacement therapy: a clinical review. Arch Intern Med 164:1965–1976CrossRefPubMed

39.

van Heerebeek L, Paulus WJ (2016) Understanding heart failure with preserved ejection fraction: where are we today? Netherlands Hear J 24:227–236CrossRef

40.

Andersson C, Vasan RS (2014) Epidemiology of heart failure with preserved ejection fraction. Hear Fail Clin 10:377–388CrossRef

41.

Meyer S, Teerlink JR, Metra M, Ponikowski P, Cotter G, Davison BA et al (2017) Sex differences in early dyspnea relief between men and women hospitalized for acute heart failure: insights from the RELAX-AHF study. Clin Res Cardiol 106:280–292CrossRefPubMed

42.

Rizkallah J, Man SFP, Sin DD (2009) Prevalence of pulmonary embolism in acute exacerbations of COPD: a systematic review and metaanalysis. Chest 135:786–793CrossRefPubMed

43.

Jois-Bilowich P, Michota F, Bartholomew JR, Glauser J, Diercks D, Weber J et al (2008) Venous thromboembolism prophylaxis in hospitalized heart failure patients. J Card Fail 14:127–132CrossRefPubMed

44.

Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Drazner MH et al (2013) 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 62:e147–e239CrossRefPubMed

45.

Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JGF, Coats AJS et al (2016) 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 37:2129–2200CrossRefPubMed

46.

Cohen AT, Harrington RA, Goldhaber SZ, Hull RD, Wiens BL, Gold A et al (2016) Extended thromboprophylaxis with betrixaban in acutely Ill medical patients. N Engl J Med 375:534–544CrossRefPubMed

47.

Hull RD, Schellong SM, Tapson VF, Monreal M, Samama MM, Nicol P et al (2010) Extended-duration venous thromboembolism prophylaxis in acutely ill medical patients with recently reduced mobility: a randomized trial. Ann Intern Med 153:8–18CrossRefPubMed

48.

Albertsen IE, Larsen TB, Rasmussen LH, Overvad TF, Lip GY (2012) Prevention of venous thromboembolism with new oral anticoagulants versus standard pharmacological treatment in acute medically ill patients. A systematic review and meta-analysis. Drugs 72:1755–1764CrossRefPubMed

49.

Raskob GE, Spyropoulos AC, Zrubek J, Ageno W, Albers G, Elliott G et al (2016) The MARINER trial of rivaroxaban after hospital discharge for medical patients at high risk of VTE. Design, rationale, and clinical implications. Thromb Haemost 115:1240–1248CrossRefPubMed

50.

Mard S, Nielsen FE (2010) Positive predictive value and impact of misdiagnosis of a heart failure diagnosis in administrative registers among patients admitted to a University Hospital cardiac care unit. Clin Epidemiol 2:235–239PubMedPubMedCentral

Titel: Sex differences in risk of incident venous thromboembolism in heart failure patients
verfasst von: Line Melgaard
Peter Brønnum Nielsen
Thure Filskov Overvad
Flemming Skjøth
Gregory Y. H. Lip
Torben Bjerregaard Larsen
Publikationsdatum: 21.08.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Clinical Research in Cardiology / Ausgabe 1/2019
Print ISSN: 1861-0684
Elektronische ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-018-1329-9

Neu im Fachgebiet Kardiologie

19.04.2024 | Vorhofflimmern | Nachrichten

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Sex differences in risk of incident venous thromboembolism in heart failure patients

Abstract

Background

Methods

Results

Conclusions

Neu im Fachgebiet Kardiologie

Parodontalbehandlung verbessert Prognose bei Katheterablation

Antihypertensiva schützen auch alte Menschen noch vor Demenz

Sind Betablocker auch für ältere herzschwache Personen nützlich?

Stillende Frauen haben geringeres kardiovaskuläres Risiko

Update Kardiologie

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Background

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 1/2019

Correction to: Transcatheter valve-in-valve implantation (VinV-TAVR) for failed surgical aortic bioprosthetic valves

Prognostic significance of atrial fibrillation in acute decompensated heart failure with reduced versus preserved ejection fraction

Novel ECG-based scoring tool for prediction of takotsubo syndrome

Follow-up of the first patients with a totally subcutaneous ICD in Germany from implantation till battery depletion

Long-term effects of iron deficiency in patients with heart failure with or without anemia: the RAID-HF follow-up study

Correction to: Integrating basic science in academic cardiology training: two international perspectives on a common challenge

Neu im Fachgebiet Kardiologie

Parodontalbehandlung verbessert Prognose bei Katheterablation

Antihypertensiva schützen auch alte Menschen noch vor Demenz

Sind Betablocker auch für ältere herzschwache Personen nützlich?

Stillende Frauen haben geringeres kardiovaskuläres Risiko

Update Kardiologie