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Microscopic Colitis and Risk of Venous Thromboembolism: A Nationwide Matched Cohort Study
Anders Forss1,2,3, Gabriella Bröms3,4, David Bergman1
1Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
The American Journal of Gastroenterology
|March 13, 2025
Summary
Individuals with microscopic colitis (MC) have a significantly higher risk of venous thromboembolism (VTE). This population-based study found a 21% increased VTE risk, highlighting a need for increased awareness and monitoring in MC patients.
Area of Science:
- Gastroenterology
- Hematology
- Epidemiology
Background:
- Inflammatory diseases are linked to an increased risk of venous thromboembolism (VTE).
- Limited data exist on VTE risk within large population-based cohorts of microscopic colitis (MC).
Purpose of the Study:
- To investigate the association between microscopic colitis (MC) and the risk of venous thromboembolism (VTE).
- To quantify the risk of VTE in individuals diagnosed with MC compared to the general population.
Main Methods:
- A population-based cohort study of Swedish adults diagnosed with incident MC between 1990-2017.
- Matched comparison of MC patients (n=12,489) with general population reference individuals (n=55,809).
- VTE events were identified and analyzed using Cox proportional hazards modeling, with sensitivity analyses for robust findings.
Main Results:
- Individuals with MC experienced a higher incidence of VTE (11.3/1,000 person-years) compared to reference individuals (8.6/1,000 person-years).
- MC patients showed a 21% increased overall risk of VTE (aHR 1.21, 95% CI 1.11-1.32).
- Elevated risks were observed for pulmonary embolism, deep vein thrombosis of the legs, and other VTE events.
Conclusions:
- Microscopic colitis is associated with a significantly elevated risk of venous thromboembolism.
- The findings suggest that MC patients require closer monitoring for VTE development.
- An increased VTE risk equivalent to 1 extra event per 37 MC patients over 10 years underscores clinical significance.
