Risk Factors Associated with Myocardial Infarction in Venous Thromboembolism Patients.
Curr Med Res Opin. 2013 Oct 9;
Authors: Laliberté F, Nutescu E, Lefebvre P, Rondeau-Leclaire J, Bookhart B, Lamori J, Damaraju C, Schein J, Kaatz S
Abstract BACKGROUND: Although risk factors for MI have been described in the general population, there is a lack of data on the assessment of risk factors associated with MI in venous thromboembolism (VTE) patients.
OBJECTIVE: The purpose of this study was to identify risk factors associated with MI in VTE patients.
PATIENTS/METHODS: Health insurance claims between 01/2004 and 09/2008 from the Ingenix IMPACT database were analyzed. Patients aged ≥18 years were identified as of the date of their first VTE diagnosis with ≥1 year of continuous insurance coverage before the index VTE. The risk of MI for VTE patients with 1, 2, and ≥3 major risk factors as identified by published guidelines was calculated. Multivariate Cox proportional hazard models were conducted to identify the most predictive risk factors associated with MI.
RESULTS: A total of 177,885 VTE patients were identified; 4412 (2.5%) developed an MI during a mean follow-up period of 1.3 years. Previous MI, age (≥65 years), and coronary artery disease were the most predictive risk factors of MI with adjusted hazard ratios (HRs; 95% CI) of 5.47 (5.01-5.97), 1.78 (1.66-1.91), and 1.60 (1.48-1.74), respectively. Adjusted HRs (95% CI) for VTE patients with 1, 2, >3 major risk factors relative to no major risk factor were 2.34 (1.94-2.81), 3.21 (2.67-3.85), and 6.93 (5.85-8.22), respectively.
LIMITATIONS: These included possible inaccuracies or omissions in diagnoses, classification bias such as the identification of false-positive MI events, and the likely undercoding of some risk factors such as social issues.
CONCLUSIONS: Traditional major cardiovascular risk factors are also predictive of MI in VTE patients. Having multiple major risk factors significantly increases the probability of developing MI events in VTE patients.
PMID: 24102370 [PubMed - as supplied by publisher]