静脈血栓塞栓症と診断された患者の心血管疾患のリスク
Frida Lonnberg1, Anwar J Siddiqui1
1Department of Medicine, Karolinska Institute, Solna; Acute and Reparative Medicine Theme, Karolinska University Hospital, Stockholm, Sweden.
The American journal of medicine
|August 31, 2025
まとめ
静脈性血栓塞栓症 (VTE) は,動脈性心血管疾患 (ACVE) のリスクを増加させない. しかし,深静脈血栓症 (DVT) と肺栓塞症 (PE) の両方が,すべての原因による死亡率に著しく関連しています.
科学分野:
- 心臓病科
- 血管医学
- エピデミオロジー
背景:
- 心血管疾患 (CVD) は世界的に大きな健康問題です.
- 静脈性血栓塞栓症 (VTE) とその後の動脈性心血管疾患 (ACVE) の関係については,さらなる調査が必要である.
- この関連性を理解することは 患者のリスクの階層化と管理に不可欠です
研究 の 目的:
- 静脈血栓塞栓症 (VTE) と診断された患者の将来の動脈性心血管疾患 (ACVE) のリスクを調査する.
- 深静脈血栓症 (DVT) または肺栓塞症 (PE) の患者のACVE発生率を対照群と比較する.
- すべての原因による死亡率に対するVTEの影響を評価する.
主な方法:
- ストックホルムの緊急治療室 (ED) に出院する成人のコホート研究 (2016年−2017年).
- 以前 ACVE を患っていた患者を除いて,DVTまたはPEと診断された患者を含む.
- ACVEと死亡率の調整された危険比率 (HRs) を推定するために使用された,Fine-Grayサブディストリビューションの危険モデルで,ACVEの平均追跡期間は1.2年,死亡率は2.1年.
主要な成果:
- この研究には308,779人の患者が含まれており,そのうち3,610人がDVT,2,358人がPEでした.
- DVT患者におけるACVEの調整HRは,完全なフォローアップで0. 74 (95%CI,0. 59- 0. 94) であり,PE患者ではHRは0. 86 (95%CI,0. 67- 1. 12) であった.
- すべての原因による死亡率は,対照群と比較して,DVT (HR1. 64) と PE (HR2. 37) の両方に著しく上昇した.
結論:
- 静脈性血栓塞栓症 (VTE) は,その後の動脈性心血管疾患 (ACVE) のリスク増加と関連しませんでした.
- 深静脈血栓症 (DVT) と肺栓塞症 (PE) は,全因死亡率の増加と有意に関連していました.
- これらの発見は,直接の血栓形成のリスクを超えるVTE管理の重要性を強調しています.
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