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Risk of venous thromboembolism in patients with congenital heart disease: a nationwide, register-based, case-control

Dagmara Cuszynska-Kruk1, Maria Fedchenko1,2, Kok Wai Giang1,2

  • 1Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Diagnosvägen 11, SE-416 50 Gothenburg, Sweden.

European Heart Journal Open
|November 4, 2024
PubMed

Insights

Patients with congenital heart disease (CHD) face a significantly higher risk of venous thromboembolism (VTE). This nationwide study found VTE risk to be over three times greater in CHD patients compared to controls.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Public Health

Background:

  • Congenital heart disease (CHD) patients have increased risks for acquired cardiovascular conditions.
  • The specific risk of venous thromboembolism (VTE) in CHD populations remains largely uncharacterized.

Purpose of the Study:

  • To determine the incidence and risk of VTE in individuals with CHD.
  • To compare VTE risk between patients with CHD and matched controls without CHD.

Main Methods:

  • Utilized Swedish health registers to identify CHD patients (1970-2017).
  • Matched each CHD patient with 10 controls from the Swedish Total Population Register.
  • Employed Cox proportional hazard models for risk analysis, with follow-up until VTE, death, or end of study.

Main Results:

  • Included 67,814 CHD patients and 583,709 controls.
  • Observed VTE in 0.8% of CHD patients versus 0.3% of controls.
  • Found VTE risk to be 3.3 times higher in CHD patients (HR 3.3, 95% CI 2.6-3.4).
  • Conotruncal defects were associated with the highest VTE risk (HR 7.06, 95% CI 5.52-9.03).

Conclusions:

  • Patients with CHD exhibit a substantially elevated risk of VTE, more than threefold higher than controls.
  • The most complex congenital heart lesions are linked to the greatest VTE risk.
  • Further investigation is essential to identify VTE risk factors and develop preventive strategies for CHD patients.
Abstract

Keywords:
Congenital heart diseaseNationwide studyRegister basedVenous thromboembolism

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