Heart Failure Is Associated with Increased Risk of Long-Term Venous Thromboembolism

Venous thromboembolism (VTE), consisting of deep vein thrombosis (DVT) and pulmonary embolism (PE), is highly prevalent in in-hospital HF patients and contributes to worse prognoses. However, the risk of VTE in out-patients with HF in long-term period is controversial. This study aimed to evaluate the associations between HF and the risk of VTE in a long-term follow-up duration.

We searched for studies investigating the risk of VTE, PE, and DVT in patients with HF before April 15, 2020, in PubMed, MEDLINE, and Embase databases. Cohort studies and post hoc analysis of RCTs were eligible for inclusion if they reported relative risk of VTE, DVT or PE in patients with HF in more than 3-month follow-up period.

We identified 31 studies that enrolled over 530,641 HF patients. Overall, patients with HF were associated with an increased risk of VTE (risk ratio [RR]=1.57, 95% confidence interval [CI]=1.34-1.84) and PE (RR=2.00, 95% CI=1.38-2.89). However, the risk of DVT was not significantly increased in HF patients (RR=1.33, 95% CI=0.67-2.63). Subgroup analysis showed that patients with chronic HF (RR=1.54, 95% CI=1.32-1.80) had a higher risk of VTE than those with acute HF (RR=0.95, 95% CI=0.68-1.32).

In conclusion, HF was an independent risk for VTE and PE but not DVT in a long-term follow-up period. Patients with chronic HF were prone to suffer from VTE than acute HF.