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Primary care diagnosed multimorbidity and risk of venous thromboembolism in Sweden

Ahrén, Jonatan LU orcid ; Pirouzifard, Mir Nabi LU ; Holmquist, Björn LU orcid ; Sundquist, Jan LU ; Sundquist, Kristina LU and Zöller, Bengt LU orcid (2026) In International Journal of Cardiology: Cardiovascular Risk and Prevention 29.
Abstract

Background Multimorbidity, the co-occurrence of two or more non-communicable diseases (NCDs), is common and has been linked to venous thromboembolism (VTE). Whether multimorbidity diagnosed in primary-care is associated with incident VTE remains unclear. We aimed to examine this association. Methods Multimorbidity was defined using Swedish primary-care data. Individuals without prior VTE were included, and incident VTE was identified through the Swedish National Patient Register. Primary-care multimorbidity was defined as two or more NCDs. Subdistribution hazard ratios (subHRs) for VTE were estimated adjusting for sociodemographic factors and acquired and inherited VTE risk factors. The VTE risk of nine disease clusters were... (More)

Background Multimorbidity, the co-occurrence of two or more non-communicable diseases (NCDs), is common and has been linked to venous thromboembolism (VTE). Whether multimorbidity diagnosed in primary-care is associated with incident VTE remains unclear. We aimed to examine this association. Methods Multimorbidity was defined using Swedish primary-care data. Individuals without prior VTE were included, and incident VTE was identified through the Swedish National Patient Register. Primary-care multimorbidity was defined as two or more NCDs. Subdistribution hazard ratios (subHRs) for VTE were estimated adjusting for sociodemographic factors and acquired and inherited VTE risk factors. The VTE risk of nine disease clusters were investigated. Results Among 8,170,329 included individuals, 2,183,236 (26.72%) had primary care-diagnosed multimorbidity. Adjusted subHR for VTE among individuals with multimorbidity was 1.36 (95%CI 1.34-1.39). A dose-response association was observed, a subHR of 1.62 (95%CI 1.57-1.67) for individuals with ≥5 NCDs. There were significant interactions between multimorbidity and sex and country of birth. Seven of nine multimorbidity clusters were associated with increased VTE risk. Conclusion Primary care-diagnosed multimorbidity is an independent, dose-dependent risk factor for VTE. The association between several disease-clusters and VTE suggests potential value in cluster-based risk prediction.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Epidemiology, Medicine, Multimorbidity, Primary care, Public health, Venous thromboembolism
in
International Journal of Cardiology: Cardiovascular Risk and Prevention
volume
29
article number
200631
publisher
Elsevier
external identifiers
  • pmid:42003871
  • scopus:105035117928
ISSN
2772-4875
DOI
10.1016/j.ijcrp.2026.200631
language
English
LU publication?
yes
id
7f601b0b-1b4c-45de-98e2-405353fdea91
date added to LUP
2026-05-11 10:51:53
date last changed
2026-09-02 01:49:12
@article{7f601b0b-1b4c-45de-98e2-405353fdea91,
  abstract     = {{<p>Background Multimorbidity, the co-occurrence of two or more non-communicable diseases (NCDs), is common and has been linked to venous thromboembolism (VTE). Whether multimorbidity diagnosed in primary-care is associated with incident VTE remains unclear. We aimed to examine this association. Methods Multimorbidity was defined using Swedish primary-care data. Individuals without prior VTE were included, and incident VTE was identified through the Swedish National Patient Register. Primary-care multimorbidity was defined as two or more NCDs. Subdistribution hazard ratios (subHRs) for VTE were estimated adjusting for sociodemographic factors and acquired and inherited VTE risk factors. The VTE risk of nine disease clusters were investigated. Results Among 8,170,329 included individuals, 2,183,236 (26.72%) had primary care-diagnosed multimorbidity. Adjusted subHR for VTE among individuals with multimorbidity was 1.36 (95%CI 1.34-1.39). A dose-response association was observed, a subHR of 1.62 (95%CI 1.57-1.67) for individuals with ≥5 NCDs. There were significant interactions between multimorbidity and sex and country of birth. Seven of nine multimorbidity clusters were associated with increased VTE risk. Conclusion Primary care-diagnosed multimorbidity is an independent, dose-dependent risk factor for VTE. The association between several disease-clusters and VTE suggests potential value in cluster-based risk prediction.</p>}},
  author       = {{Ahrén, Jonatan and Pirouzifard, Mir Nabi and Holmquist, Björn and Sundquist, Jan and Sundquist, Kristina and Zöller, Bengt}},
  issn         = {{2772-4875}},
  keywords     = {{Epidemiology; Medicine; Multimorbidity; Primary care; Public health; Venous thromboembolism}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{International Journal of Cardiology: Cardiovascular Risk and Prevention}},
  title        = {{Primary care diagnosed multimorbidity and risk of venous thromboembolism in Sweden}},
  url          = {{http://dx.doi.org/10.1016/j.ijcrp.2026.200631}},
  doi          = {{10.1016/j.ijcrp.2026.200631}},
  volume       = {{29}},
  year         = {{2026}},
}