Microscopic colitis and risk of venous thromboembolism : A nationwide matched cohort study
Forss, Anders ; Bröms, Gabriella ; Bergman, David ; Thuresson, Marcus ; Sun, Jiangwei ; Eriksson, Carl ; Olén, Ola ; Zöller, Bengt LU
and Ludvigsson, Jonas F.
(2025)
In American Journal of Gastroenterology
- Abstract
Introduction: Inflammatory diseases have been associated with increased risk of venous thromboembolism (VTE). However, data on VTE is lacking in large population-based cohorts of microscopic colitis (MC). Methods: This study included all Swedish adults with incident MC without prior VTE (1990-2017; n=12,489; follow-up until 2021). MC and subtypes (collagenous colitis and lymphocytic colitis) were defined from prospectively recorded colorectal histopathology reports from all 28 pathology departments in Sweden. Individuals with MC were matched for birth year, sex, calendar year and county with up to five general population reference individuals (n=55, 809) without prior MC. Sensitivity analyses included full sibling comparisons and... (More)
Introduction: Inflammatory diseases have been associated with increased risk of venous thromboembolism (VTE). However, data on VTE is lacking in large population-based cohorts of microscopic colitis (MC). Methods: This study included all Swedish adults with incident MC without prior VTE (1990-2017; n=12,489; follow-up until 2021). MC and subtypes (collagenous colitis and lymphocytic colitis) were defined from prospectively recorded colorectal histopathology reports from all 28 pathology departments in Sweden. Individuals with MC were matched for birth year, sex, calendar year and county with up to five general population reference individuals (n=55, 809) without prior MC. Sensitivity analyses included full sibling comparisons and stricter definitions of VTE requiring a primary diagnosis of VTE and a prescription of anticoagulant medication. Incidence rates and multivariable-adjusted hazard ratios (aHRs) and 95% confidence intervals (CI) for VTE events were calculated using Cox proportional hazards modelling. Results: Over a median of 10.0 years of follow-up, 755 (6.0%; 11.3/1000 person-years) incident VTE events occured in individuals with MC and 2674 (4.8%; 8.6/1000 person-years) in reference individuals. Individuals with MC had a higher overall relative risk of any VTE event compared with reference individuals (aHR=1.21, 95%CI=1.11-1.32) including higher risk of pulmonary embolism (aHR=1.23, 95%CI=1.08-1.40), deep vein thrombosis of the legs (aHR=1.16, 95%CI=1.03-1.32), and other VTE events (aHR=1.31, 95%CI=1.08-1.58). The results remained robust in sensitivity analyses. Discussion: In this population-based study, individuals with MC had a 21% higher risk of VTE compared with reference individuals, equivalent to one extra VTE event for every 37 MC individuals followed for ten years.
(Less)
- author
- Forss, Anders
; Bröms, Gabriella
; Bergman, David
; Thuresson, Marcus
; Sun, Jiangwei
; Eriksson, Carl
; Olén, Ola
; Zöller, Bengt
LU
and Ludvigsson, Jonas F.
- organization
- publishing date
- 2025
- type
- Contribution to journal
- publication status
- epub
- subject
- keywords
- biopsy, epidemiology, inflammatory bowel disease, microscopic colitis, venous thromboembolism
- in
- American Journal of Gastroenterology
- publisher
- Wolters Kluwer
- external identifiers
-
- scopus:105003039962
- pmid:40079472
- ISSN
- 0002-9270
- DOI
- 10.14309/ajg.0000000000003408
- language
- English
- LU publication?
- yes
- id
- 1103d8bb-469f-409d-adbb-60801769eb4f
- date added to LUP
- 2025-09-01 12:25:30
- date last changed
- 2025-10-14 13:23:00
@article{1103d8bb-469f-409d-adbb-60801769eb4f,
abstract = {{<p>Introduction: Inflammatory diseases have been associated with increased risk of venous thromboembolism (VTE). However, data on VTE is lacking in large population-based cohorts of microscopic colitis (MC). Methods: This study included all Swedish adults with incident MC without prior VTE (1990-2017; n=12,489; follow-up until 2021). MC and subtypes (collagenous colitis and lymphocytic colitis) were defined from prospectively recorded colorectal histopathology reports from all 28 pathology departments in Sweden. Individuals with MC were matched for birth year, sex, calendar year and county with up to five general population reference individuals (n=55, 809) without prior MC. Sensitivity analyses included full sibling comparisons and stricter definitions of VTE requiring a primary diagnosis of VTE and a prescription of anticoagulant medication. Incidence rates and multivariable-adjusted hazard ratios (aHRs) and 95% confidence intervals (CI) for VTE events were calculated using Cox proportional hazards modelling. Results: Over a median of 10.0 years of follow-up, 755 (6.0%; 11.3/1000 person-years) incident VTE events occured in individuals with MC and 2674 (4.8%; 8.6/1000 person-years) in reference individuals. Individuals with MC had a higher overall relative risk of any VTE event compared with reference individuals (aHR=1.21, 95%CI=1.11-1.32) including higher risk of pulmonary embolism (aHR=1.23, 95%CI=1.08-1.40), deep vein thrombosis of the legs (aHR=1.16, 95%CI=1.03-1.32), and other VTE events (aHR=1.31, 95%CI=1.08-1.58). The results remained robust in sensitivity analyses. Discussion: In this population-based study, individuals with MC had a 21% higher risk of VTE compared with reference individuals, equivalent to one extra VTE event for every 37 MC individuals followed for ten years.</p>}},
author = {{Forss, Anders and Bröms, Gabriella and Bergman, David and Thuresson, Marcus and Sun, Jiangwei and Eriksson, Carl and Olén, Ola and Zöller, Bengt and Ludvigsson, Jonas F.}},
issn = {{0002-9270}},
keywords = {{biopsy; epidemiology; inflammatory bowel disease; microscopic colitis; venous thromboembolism}},
language = {{eng}},
publisher = {{Wolters Kluwer}},
series = {{American Journal of Gastroenterology}},
title = {{Microscopic colitis and risk of venous thromboembolism : A nationwide matched cohort study}},
url = {{http://dx.doi.org/10.14309/ajg.0000000000003408}},
doi = {{10.14309/ajg.0000000000003408}},
year = {{2025}},
}