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Comorbidity and risk of venous thromboembolism after hospitalization for first-time myocardial infarction: A

Morten Würtz1,2,3, Erik Lerkevang Grove3,4, Priscila Corraini1

  • 1Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.

Journal of Thrombosis and Haemostasis : JTH
|April 23, 2020
PubMed

Insights

Myocardial infarction (MI) significantly increases venous thromboembolism (VTE) risk. Comorbidities like cancer and hemiplegia further elevate this risk, suggesting a need for targeted VTE prophylaxis in high-risk patients post-MI.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Epidemiology

Background:

  • Myocardial infarction (MI) is a known risk factor for venous thromboembolism (VTE).
  • The influence of comorbidities on VTE risk following MI remains unclear.
  • Understanding these factors is crucial for patient prognosis and management.

Purpose of the Study:

  • To investigate the impact of comorbidities on the risk of VTE after MI.
  • To quantify the excess VTE risk associated with the combination of MI and specific comorbidities.
  • To identify which comorbidities most significantly contribute to post-MI VTE risk.

Main Methods:

  • Nationwide population-based registries in Denmark (1995-2013) were utilized.
  • A cohort of first-time MI patients was compared to a matched general population cohort (5:1 ratio).
  • Cumulative risks, rates, hazard ratios, and interaction contrasts for VTE were calculated at 30 days and 1-12 months post-MI.

Main Results:

  • Thirty-day VTE risk was 0.6% in MI patients versus 0.03% in controls; 1-year risk was 0.5% vs 0.3%.
  • The 30-day hazard ratio for VTE post-MI was 23, decreasing over follow-up.
  • Comorbidities, particularly hemiplegia and cancer, substantially increased VTE risk, accounting for 16-39% of VTE rates in affected MI patients.

Conclusions:

  • VTE risk is markedly elevated in the 30 days following MI compared to the general population.
  • Comorbidities significantly amplify the absolute VTE risk post-MI, with hemiplegia and cancer being key drivers.
  • Further research into VTE prophylaxis for high-risk MI patients with comorbidities is warranted.
Abstract

Keywords:
comorbidityepidemiologymyocardial infarctionpulmonary embolismvenous thrombosis

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