title: Cardiovascular disease and mortality after a first episode of venous thromboembolism in young and middle-aged women.
abstract: BACKGROUND
  Patients with a history of venous thromboembolism (VTE) seem to have an increased risk of arterial cardiovascular disease (CVD).
  
  
  OBJECTIVE
  To evaluate the risk of CVD and overall mortality after a first episode of VTE in women and to assess common risk factors for VTE and CVD.
  
  
  METHODS
  We performed a cohort study inviting 1433 women with a previous VTE (exposed) and 1402 women without VTE (unexposed). The cohort was derived from TEHS, a Swedish population-based case-control study on risk factors for VTE in women age 18-64years. The women were recruited in 2002-2009. During 2011 information on CVD and mortality was obtained from a questionnaire and from the Swedish Patient Register and the Cause of Death Register. Hazard ratios (HR) for CVD and their 95% confidence intervals (CI) were calculated using Cox regression. In multivariate analyses we adjusted for age, smoking, diabetes mellitus, hypertension and body mass index.
  
  
  RESULTS
  2108 (75%) women (mean age 47±13years) accepted participation. During the total follow up of 11,920 person years 35 (3.2%, 95% CI 0.7-2.1) among the exposed and 14 (1.4%, 95% CI 0.2-4.3) among the unexposed had any CVD event. The adjusted HR for CVD was 2.0 (95% CI 1.1-3.9) the adjusted HR for mortality was 2.3 (95% CI 1.2-4.6) CONCLUSION: Women with a previous VTE had a two-fold increased risk of CVD and overall mortality. Adjusting for cardiovascular risk factors only modestly changed the estimates.
authors.affiliation: Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; Haematology Centre, Karolinska University Hospital, Solna, Stockholm, Sweden. Electronic address: maria.ljungqvist@ki.se.
authors.forename: Maria
authors.initials: M
authors.lastname: Ljungqvist
authors.affiliation: Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Haematology Centre, Karolinska University Hospital, Solna, Stockholm, Sweden.
authors.forename: Margareta
authors.initials: M
authors.lastname: Holmström
authors.affiliation: Centre for Pharmacoepidemiology, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Helle
authors.initials: H
authors.lastname: Kieler
authors.affiliation: Haematology Centre, Karolinska University Hospital, Solna, Stockholm, Sweden; Department of Proteomics, School of Biotechnology, KTH, Science for Life Laboratory, Stockholm, Sweden.
authors.forename: Jacob
authors.initials: J
authors.lastname: Odeberg
authors.affiliation: Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; Department of Internal Medicine, Södersjukhuset, Stockholm, Sweden.
authors.forename: Gerd
authors.initials: G
authors.lastname: Lärfars
mesh_terms: D000293:Adolescent; D000328:Adult; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000401:mortality*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000150:complications*; D055815:Young Adult
keywords: Cardiovascular disease; Cohort studies; Mortality; Venous thromboembolism; Women