Incidence and risk of venous thromboembolism in patients with verified arterial thrombosis: a population study based on 23,796 consecutive autopsies.
BACKGROUND
The relationship between atherothrombotic disease and venous thromboembolism (VTE) remains unclear.


METHODS
In a cohort of 23,796 consecutive autopsies, performed using a standardized procedure and representing 84% of all in-hospital deaths between 1970 and 1982 in an urban Swedish population, we investigated the relationship between verified arterial thrombosis and VTE, with the hypothesis that patients with thrombosis in major artery segments have increased odds of VTE.


RESULTS
We found an increased risk of VTE in patients with arterial thrombosis (Odds ratio; OR adjusted for gender and age 1.4, 95% confidence interval; CI 1.3-1.5) (P < 0.001). Patients with cervico-cranial and peripheral artery thrombosis had an excess risk even when controlling for age and major concomitant diseases. A negative association between coronary thrombosis and VTE in the univariate analysis (OR 0.7; 95% CI 0.6-0.8) (P < 0.001), was less pronounced in the multivariate analysis (OR 0.8; 95% CI 0.7-1.0) (P = 0.016).


CONCLUSIONS
A positive association between atherothrombosis and VTE was confirmed, except in patients with coronary thrombosis, where IHD as competing death cause is a possible confounder. Our findings indicate a potential for directed prevention, but may also imply similarities in etiology.
Eliasson
A
A
Department of Vascular Surgery, Uppsala University Hospital, Uppsala, Sweden.
Bergqvist
D
D
Björck
M
M
Acosta
S
S
Sternby
N H
NH
Ogren
M
M
D000368:Aged; D000704:Analysis of Variance; D001157:Arterial Occlusive Diseases / Q000453:epidemiology* / Q000209:etiology; D001344:Autopsy; D015331:Cohort Studies; D003328:Coronary Thrombosis; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D020767:Intracranial Thrombosis; D016017:Odds Ratio; D016491:Peripheral Vascular Diseases; D012306:Risk; D013548:Sweden / Q000453:epidemiology; D013923:Thromboembolism / Q000453:epidemiology* / Q000209:etiology; D020246:Venous Thrombosis / Q000453:epidemiology* / Q000209:etiology