Center of Thrombosis and Drug Research, Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.
Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Faculty of Health, Aalborg University, Aalborg, Denmark.
Clin Res Cardiol. 2019 Jan;108(1):101-109. doi: 10.1007/s00392-018-1329-9. Epub 2018 Aug 21.
In patients with incident heart failure, the risk of venous thromboembolism (VTE), defined as pulmonary embolism (PE) and/or deep venous thrombosis (DVT), is sparsely described, especially potential sex differences. We conducted an observational study to evaluate risk of VTE among male and female heart failure patients.
Population-based cohort study of patients diagnosed with incident heart failure during 2000-2015, identified by record linkage between nationwide registries in Denmark. Using a pseudo-value approach, we calculated relative risks [RR] of VTE at 1 and 3 years of follow-up. Crude VTE risk for males and females are reported and contrasted after adjustment for established clinical risk factors for VTE.
A total of 32,330 heart failure patients were included, of which 15,238 (47%) were females. For the combined endpoint of VTE, female sex was associated with a higher risk (1-year adjusted RR: 1.30, 95% confidence interval [CI]: 0.97-1.73; 3-year adjusted RR: 1.34, 95% CI: 1.07-1.67) compared to male patients. For the individual endpoints of PE and DVT after 1-year of follow-up, female sex was only associated with a higher risk of PE and not DVT, compared to male patients. However, female sex was associated with a higher risk of both PE and DVT after 3 years of follow-up.
Among incident heart failure patients, female sex is associated with a higher risk of VTE, mainly driven by an excess risk of PE. This finding may help improve clinical decision-making regarding VTE prophylaxis in patients with heart failure.
在新发心力衰竭患者中，静脉血栓栓塞症（VTE）的风险（定义为肺栓塞[PE]和/或深静脉血栓形成[DVT]）描述甚少，尤其是潜在的性别差异。我们进行了一项观察性研究，以评估男性和女性心力衰竭患者的 VTE 风险。
这是一项基于人群的队列研究，纳入了 2000 年至 2015 年期间通过丹麦全国性登记处记录链接诊断为新发心力衰竭的患者。我们使用伪值方法，计算了 1 年和 3 年随访时 VTE 的相对风险[RR]。报告了男性和女性的粗 VTE 风险，并在调整了 VTE 的既定临床危险因素后进行了比较。
共纳入 32330 例心力衰竭患者，其中 15238 例（47%）为女性。对于 VTE 的联合终点，与男性患者相比，女性性别与更高的风险相关（1 年校正 RR：1.30，95%置信区间[CI]：0.97-1.73；3 年校正 RR：1.34，95% CI：1.07-1.67）。对于 1 年后的 PE 和 DVT 这两个单一终点，与男性患者相比，女性性别仅与更高的 PE 风险相关，而与 DVT 风险无关。然而，在 3 年随访后，女性性别与 PE 和 DVT 的双重风险增加相关。
在新发心力衰竭患者中，女性性别与 VTE 风险增加相关，主要是由于 PE 的风险增加。这一发现可能有助于改善心力衰竭患者 VTE 预防的临床决策。
