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Congestive heart failure and outpatient risk of venous thromboembolism: a retrospective, case-control study

M D Howell1, J M Geraci, A A Knowlton

  • 1Cardiology Section, Department of Medicine, Houston Veterans Affairs Medical Center and Baylor College of Medicine, Houston, TX 77030, USA.

Journal of Clinical Epidemiology
|July 27, 2001
PubMed

Insights

Congestive heart failure (CHF) significantly increases the risk of venous thromboembolism in outpatients. This risk escalates with declining ventricular function, particularly with ejection fractions below 20%.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Internal Medicine

Background:

  • Congestive heart failure (CHF) is a known risk factor for venous thromboembolism (VTE), but direct evidence is limited.
  • The relationship between left ventricular dysfunction and VTE risk in outpatients requires further investigation.

Purpose of the Study:

  • To determine if CHF due to left ventricular dysfunction is an independent risk factor for acute VTE in outpatients.
  • To assess if worsening ventricular function correlates with increased VTE risk.

Main Methods:

  • A case-control study was conducted involving 106 deep vein thrombosis (DVT) cases and 603 controls admitted to a VA hospital.
  • Patients were matched for admission month and controls were admitted for diabetes mellitus or infection.
  • Logistic regression models were used to analyze the association between CHF, ejection fraction (EF), and VTE, adjusting for established risk factors.

Main Results:

  • CHF was identified as an independent predictor of VTE in the logistic regression model.
  • A significant inverse relationship was observed between EF and VTE risk.
  • An EF < 20% was associated with a high odds ratio (OR) of 38.3 for VTE.

Conclusions:

  • Congestive heart failure is an independent risk factor for venous thromboembolism.
  • The risk of VTE markedly increases as the ejection fraction decreases in CHF patients.
  • Anticoagulation therapy may be beneficial for selected CHF patients at high risk for VTE.

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