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Family history of venous thromboembolism and mortality after venous thromboembolism : a Swedish population-based cohort study

Zöller, Bengt LU ; Pirouzifard, Mirnabi LU ; Sundquist, Jan LU and Sundquist, Kristina LU (2017) In Journal of Thrombosis and Thrombolysis 43(4). p.469-475
Abstract

Studies on whether family history (FH) of venous thromboembolism (VTE) affects long-term mortality after VTE are missing. The aim of this study was to determine whether FH of VTE affects long-term mortality after a first episode of VTE. Using Swedish medical databases, we conducted a 30-year nationwide cohort study of 49,159 adult Swedish born patients included in the multi-generation register (born 1932 or later) with a first-time VTE (1981–2010). Using Cox regression, we assessed mortality Hazard ratios (HRs) with 95% confidence intervals (CIs). Totally 10,093 (20.5%) patients with VTE had a first-degree FH of VTE (parent/sibling). Patients without FH of VTE had significantly more VTE provoking risk factors and comorbidities than... (More)

Studies on whether family history (FH) of venous thromboembolism (VTE) affects long-term mortality after VTE are missing. The aim of this study was to determine whether FH of VTE affects long-term mortality after a first episode of VTE. Using Swedish medical databases, we conducted a 30-year nationwide cohort study of 49,159 adult Swedish born patients included in the multi-generation register (born 1932 or later) with a first-time VTE (1981–2010). Using Cox regression, we assessed mortality Hazard ratios (HRs) with 95% confidence intervals (CIs). Totally 10,093 (20.5%) patients with VTE had a first-degree FH of VTE (parent/sibling). Patients without FH of VTE had significantly more VTE provoking risk factors and comorbidities than those with FH. The mortality HR the first 10-years after first time VTE was decreased for those with FH of VTE compared to for those without FH: crude HR 0.807, 95% CI 0.771–0.845 and adjusted HR 0.864, 95% CI 0.826–0.905. After 10-years of follow-up there was no significant effect of FH of VTE on mortality: crude HR = 1.018, 95% CI 0.905–1.145 and adjusted HR = 0.995, 95% CI 0.884–1.119. Cancer-associated mortality was more common in those without FH the first 10 years (56.9 vs. 53.4%, p = 0.002). After 10 years there were no difference in cancer-associated mortality (4.9 vs. 5.6%, p = 0.604). The results suggest that patients with FH of VTE have lower thrombotic threshold and need less provoking factors and comorbidities. They have also slightly lower total and cancer mortality the first 10 years after VTE.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Comorbidity, Deep venous thrombosis, Family history, Genetics, Mortality, Pulmonary embolism, Venous thromboembolism
in
Journal of Thrombosis and Thrombolysis
volume
43
issue
4
pages
469 - 475
publisher
Springer
external identifiers
  • scopus:85006378323
  • wos:000399021200006
ISSN
0929-5305
DOI
10.1007/s11239-016-1464-y
language
English
LU publication?
yes
id
64980ec6-4395-49a3-af22-b953be6aa9e1
date added to LUP
2017-01-11 12:41:06
date last changed
2018-01-07 11:44:14
@article{64980ec6-4395-49a3-af22-b953be6aa9e1,
  abstract     = {<p>Studies on whether family history (FH) of venous thromboembolism (VTE) affects long-term mortality after VTE are missing. The aim of this study was to determine whether FH of VTE affects long-term mortality after a first episode of VTE. Using Swedish medical databases, we conducted a 30-year nationwide cohort study of 49,159 adult Swedish born patients included in the multi-generation register (born 1932 or later) with a first-time VTE (1981–2010). Using Cox regression, we assessed mortality Hazard ratios (HRs) with 95% confidence intervals (CIs). Totally 10,093 (20.5%) patients with VTE had a first-degree FH of VTE (parent/sibling). Patients without FH of VTE had significantly more VTE provoking risk factors and comorbidities than those with FH. The mortality HR the first 10-years after first time VTE was decreased for those with FH of VTE compared to for those without FH: crude HR 0.807, 95% CI 0.771–0.845 and adjusted HR 0.864, 95% CI 0.826–0.905. After 10-years of follow-up there was no significant effect of FH of VTE on mortality: crude HR = 1.018, 95% CI 0.905–1.145 and adjusted HR = 0.995, 95% CI 0.884–1.119. Cancer-associated mortality was more common in those without FH the first 10 years (56.9 vs. 53.4%, p = 0.002). After 10 years there were no difference in cancer-associated mortality (4.9 vs. 5.6%, p = 0.604). The results suggest that patients with FH of VTE have lower thrombotic threshold and need less provoking factors and comorbidities. They have also slightly lower total and cancer mortality the first 10 years after VTE.</p>},
  author       = {Zöller, Bengt and Pirouzifard, Mirnabi and Sundquist, Jan and Sundquist, Kristina},
  issn         = {0929-5305},
  keyword      = {Comorbidity,Deep venous thrombosis,Family history,Genetics,Mortality,Pulmonary embolism,Venous thromboembolism},
  language     = {eng},
  number       = {4},
  pages        = {469--475},
  publisher    = {Springer},
  series       = {Journal of Thrombosis and Thrombolysis},
  title        = {Family history of venous thromboembolism and mortality after venous thromboembolism : a Swedish population-based cohort study},
  url          = {http://dx.doi.org/10.1007/s11239-016-1464-y},
  volume       = {43},
  year         = {2017},
}