title: Risk factors of arterial cardiovascular complications in patients with prior venous thromboembolism.
abstract: BACKGROUND
  The effect of cardiovascular risk factors (CVRs) and thrombophilic defects on the risk of arterial cardiovascular complications in patients with prior venous thromboembolism (VTE) is unclear.
  
  
  OBJECTIVE
  We investigated whether the risk of arterial cardiovascular complications is increased after VTE and whether CVRs and thrombophilic defects influence this risk.
  
  
  METHODS
  Subjects were selected from three family cohorts of probands with VTE or arterial cardiovascular complication before the age of 50 and thrombophilic defects (i.e. hyperhomocysteinaemia, prothrombin G20210A or elevated FVIII). For this analysis, probands with arterial cardiovascular complications before inclusion and their relatives as well as relatives without the studied thrombophilic defects were excluded. We calculated the incidence of arterial cardiovascular complications (e.g. myocardial infarction, ischaemic stroke, transient ischaemic attack or peripheral arterial disease) in subjects with and without VTE and adjusted the relative risk for at least one CVR, two or more thrombophilic defects and quintiles of a propensity score (considering risk factors conditional to VTE history).
  
  
  RESULTS
  861 subjects were included, of whom 399 had experienced VTE before inclusion. Twelve arterial cardiovascular complications occurred in subjects with and nine in subjects without VTE history. Hence the annual incidence was 1.0 (95% CI 0.5 to 1.7) and 0.7 (0.3 to 1.2) in subjects with and without VTE (RR 1.5, 0.6 to 3.6). Adjusting for possible confounders did not change this relative risk.
  
  
  CONCLUSIONS
  The mildly elevated risk of arterial cardiovascular complications in patients with prior VTE appears to be independent of cardiovascular risk factors and thrombophilic defects.
authors.affiliation: Department of Vascular Medicine, Academic Medical Center, Amsterdam, the Netherlands. s.roshani@lumc.nl
authors.forename: S
authors.initials: S
authors.lastname: Roshani
authors.forename: W M
authors.initials: WM
authors.lastname: Lijfering
authors.forename: M
authors.initials: M
authors.lastname: Coppens
authors.forename: K
authors.initials: K
authors.lastname: Hamulyák
authors.forename: M H
authors.initials: MH
authors.lastname: Prins
authors.forename: H R
authors.initials: HR
authors.lastname: Büller
authors.forename: S
authors.initials: S
authors.lastname: Middeldorp
mesh_terms: D000367:Age Factors; D001158:Arteries / Q000473:pathology*; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000150:complications* / Q000473:pathology