Unit for Thrombosis and Drug Research, Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.
Unit for Clinical Biostatistics, Aalborg University Hospital, Aalborg, Denmark.
Thromb Haemost. 2022 Sep;122(9):1524-1531. doi: 10.1055/s-0042-1743473. Epub 2022 Jun 10.
Cerebral venous thrombosis (CVT) is a rare manifestation of stroke and venous thromboembolism (VTE), compared with deep vein thrombosis (DVT) and pulmonary embolism (PE). We examined whether CVT was associated with adverse cardiovascular events.
A Danish cohort study with adult patients diagnosed with CVT ( = 1,015) between 1997 and 2017. We matched 10 patients with VTE (DVT and PE) to each patient with CVT for age, sex, and diagnosis year. We also matched 10 individuals from the general population to each patient with CVT. We computed cumulative incidence and estimated hazard ratios (HRs) with 95% confidence intervals (95% CIs) at 5 years for major bleeding, intracranial bleeding, ischemic stroke, and cardiovascular events. Death was examined separately.
Major bleeding risks were 1.2% for CVT and 0.7% for VTE at 6 months; these risks increased to 2.7% and 2.6%, respectively, at 5 years. Although rare, intracranial bleeding risks were markedly higher for CVT (2.9%) than for VTE (0.4%) at 5 years (HR = 8.9, 95% CI: 5.3-15.1). Incidences of ischemic stroke were 5.9% for CVT and 0.3% for VTE, at 6 months; and 10.0% and 1.4%, respectively, at 5 years (HR = 9.5, 95% CI: 7.1-12.7). In contrast, incidence of cardiac events was lower for CVT that VTE (1.7% vs. 3.6% at 5 years). Mortality risk was higher after CVT compared with VTE, at 6 months (6.6% vs. 3.8%), but the risks differed little at 5 years (14.3% vs. 14.1%).
Intracranial bleeding, ischemic stroke, and mortality risks were higher for patients with CVT than matched patients with VTE and the general population, particularly within 6 months after diagnosis.
与深静脉血栓形成（DVT）和肺栓塞（PE）相比，脑静脉血栓形成（CVT）是中风和静脉血栓栓塞症（VTE）的一种罕见表现。我们研究了 CVT 是否与不良心血管事件有关。
这是一项丹麦队列研究，纳入了 1997 年至 2017 年期间诊断为 CVT 的成年患者（n=1015）。我们将每例 CVT 患者匹配 10 例 VTE（DVT 和 PE）患者，以年龄、性别和诊断年份进行匹配。我们还将每例 CVT 患者匹配 10 名来自普通人群的个体。我们计算了主要出血、颅内出血、缺血性中风和心血管事件的 5 年累积发生率，并估计了风险比（HR）和 95%置信区间（95%CI）。分别检查了死亡情况。
6 个月时，CVT 的主要出血风险为 1.2%，VTE 为 0.7%；5 年时，这些风险分别上升至 2.7%和 2.6%。虽然罕见，但 CVT 的颅内出血风险明显高于 VTE（5 年时为 2.9%比 0.4%，HR=8.9，95%CI：5.3-15.1）。CVT 的缺血性中风发生率为 5.9%，VTE 为 0.3%，6 个月时；5 年时，CVT 和 VTE 的发生率分别为 10.0%和 1.4%（HR=9.5，95%CI：7.1-12.7）。相比之下，CVT 的心脏事件发生率低于 VTE（5 年时为 1.7%比 3.6%）。与 VTE 相比，CVT 在 6 个月时的死亡率更高（6.6%比 3.8%），但 5 年后差异不大（14.3%比 14.1%）。
与匹配的 VTE 患者和普通人群相比，CVT 患者的颅内出血、缺血性中风和死亡率风险更高，尤其是在诊断后 6 个月内。
