Arterial cardiovascular events, statins, low dose aspirin and subsequent risk of venous thromboembolism: a population-based case-control study

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Abstract

Summary Background: Atherosclerotic disease has been associated with the risk of venous thromboembolism, but the available data are conflicting. There are similar confusions regarding the association of use of aspirin and statins with venous thromboembolism. Objectives: To determine whether arterial cardiovascular events, use of statins and low dose aspirin were associated with the risk of venous thromboembolism. Patients and methods: In this population-based case-control study we identified 5824 patients with venous thromboembolism and 58 240 population controls with complete hospital and prescription history. We used logistic regression to estimate the relative risk of venous thromboembolism, adjusted for potentially confounding factors. Results: Patients with a history of arterial cardiovascular events had a clearly increased relative risk. An event within three months before the index date conferred large increases in risk, [relative risk 4.22 (95% confidence interval (CI), 2.33-7.64) after myocardial infarction, 4.41 (95% CI, 2.92-6.65) after stroke]. Myocardial infarction more than three months before the index date was not significantly associated with risk, though there was a relative risk of 1.29 (95% CI, 1.05-1.57) for myocardial infarction more than 60 months previously. A history of stroke was associated with small increases in risk after three months. Current use of statins was associated with a reduced risk of venous thromboembolism (relative risk = 0.74 (95% CI, 0.63-0.85). Aspirin use was not associated with risk. Conclusions: Patients with cardiovascular events are at short term increased risk of venous thromboembolism. Statins might prevent venous thromboembolism but aspirin does not. However, since the study is non-randomized residual confounding cannot be excluded.
Original languageEnglish
JournalJournal of Thrombosis and Haemostasis
Volume7
Issue4
Pages (from-to)521-528
Number of pages8
ISSN1538-7933
DOIs
Publication statusPublished - 2009

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