Inflammatory bowel disease is a risk factor for recurrent venous thromboembolism.
OBJECTIVE
Patients with inflammatory bowel disease (IBD) are at increased risk of a first venous thromboembolism (VTE), yet their risk of recurrent VTE is unknown. We performed a cohort study to determine the risk for recurrent VTE among patients with IBD compared with subjects without IBD.


METHODS
We assessed 2811 patients with IBD for a history of VTE, recruited from outpatient clinics at 14 referral centers (June 2006-December 2008). Patients with VTE before a diagnosis of IBD or those not confirmed to have VTE, cancer, or a VTE other than deep vein thrombosis or pulmonary embolism, were excluded. Recurrence rates were compared with 1255 prospectively followed patients without IBD that had a first unprovoked VTE (not triggered by trauma, surgery, or pregnancy). The primary end point was symptomatic, objectively confirmed, recurrent VTE after discontinuation of anticoagulation therapy after a first VTE.


RESULTS
Overall, of 116 IBD patients who had a history of first VTE, 86 were unprovoked. The probability of recurrence 5 years after discontinuation of anticoagulation therapy was higher among patients with IBD than patients without IBD (33.4%; 95% confidence interval [CI]: 21.8-45.0 vs 21.7%; 95% CI: 18.8-24.6; P = .01). After adjustment for potential confounders, IBD was an independent risk factor of recurrence (hazard ratio = 2.5; 95% CI: 1.4-4.2; P = .001).


CONCLUSIONS
Patients with IBD are at an increased risk of recurrent VTE compared to patients without IBD.
Novacek
Gottfried
G
Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria. gottfried.novacek@meduniwien.ac.at
Weltermann
Ansgar
A
Sobala
Anna
A
Tilg
Herbert
H
Petritsch
Wolfgang
W
Reinisch
Walter
W
Mayer
Andreas
A
Haas
Thomas
T
Kaser
Arthur
A
Feichtenschlager
Thomas
T
Fuchssteiner
Harry
H
Knoflach
Peter
P
Vogelsang
Harald
H
Miehsler
Wolfgang
W
Platzer
Reingard
R
Tillinger
Wolfgang
W
Jaritz
Bernhard
B
Schmid
Alfons
A
Blaha
Benedikt
B
Dejaco
Clemens
C
Eichinger
Sabine
S
D000328:Adult; D000925:Anticoagulants / Q000008:administration & dosage; D001317:Austria; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D004334:Drug Administration Schedule; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000188:drug therapy; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D020246:Venous Thrombosis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*
D000925:Anticoagulants; D005765:Gastrointestinal Agents