Anticoagulation for Venous Thromboembolism: Impact on the Risk of Major Adverse Cardiovascular Events

Chest. 2022 Jun 14:S0012-3692(22)01087-X. doi: 10.1016/j.chest.2022.05.038. Online ahead of print.ABSTRACTBACKGROUND: It was recently established that patients who developed venous thromboembolism (VTE) are at increased risk of major adverse cardiovascular events (MACE) than the general population. However, whether the anticoagulation used for VTE influences the risk of MACE remains undescribed.RESEARCH QUESTION: Does the anticoagulant treatment for VTE impact the risk of subsequent MACE?STUDY DESIGN AND METHODS: We included patients from a large prospective cohort, who received only one family of anticoagulant treatment after the acute phase of VTE, among which, vitamin K antagonist (VKA), and direct oral anticoagulants (DOAC). MACE included non-fatal acute coronary syndrome, non-fatal stroke, and all-cause death. The secondary outcome, MACE-2, included cardiovascular death instead of all-cause death. Cox proportional and Fine-Gray models served to study the relationship between anticoagulation characteristics and the risk of outcomes.RESULTS: A total of 3790 patients (47.2% of men, mean age: 60.48 years) were included. 1228 patients (32.4%) were treated for 0 to 3 months (median in overall population: 6 months). Compared to these patients, those treated for 3 to 12 (HR: 0.64, 95% CI: 0.54 - 0.76), or over 12 months (HR: 0.47, 95% CI: 0.39 - 0.56) had a significant reduced risk of MACE after adjustment for confounders. Findings were similar for MACE-2 (HR-3-12 months: 0.61, ...
Source: Chest - Category: Respiratory Medicine Authors: Source Type: research