Patients with splanchnic vein thrombosis (SVT) may be at an increased risk for bleeding and arterial cardiovascular events for years after diagnosis compared with the general population and patients with deep vein thrombosis (DVT) or pulmonary embolism (PE), according to a study published in The Lancet Haematology.
In this long-term, population-based cohort study, researchers analyzed data recorded in the Danish Civil Registration System and the Danish National Patient Registry between January 1, 1994, and November 30, 2013. All residents of Denmark are guaranteed free access to health care, and primary and secondary diagnosis records are maintained for all patients, allowing large-scale study of the 7,310,450 people living in Denmark during the study period.
The researchers estimated absolute risks and adjusted hazard ratios for the primary outcomes of bleeding and arterial cardiovascular events after diagnosis of SVT. The study included 1915 patients with SVT who were compared with 18,373 patients with DVT or PE and 19,150 individuals from the general population.
The absolute risk of bleeding in patients with SVT was high at 30 days after diagnosis (4.3%, 95% CI: 3.5-5.3) and peaked at 1 to 5 years after diagnosis (13.7%, 95% CI: 11.3-16.3). In multivariable adjusted models, the risk of bleeding at 30 days after diagnosis was nearly 40 times higher in patients with SVT (95% CI: 19.4-81.5) than in the general population and nearly 10 times higher (95% CI: 6.5-14.4) than in patients with DVT or PE.
Patients with SVT also had a high absolute risk of experiencing arterial cardiovascular events 30 days after diagnosis (3.3%, 95% CI: 2.6-4.2), and in the multivariable adjusted models, the risk of arterial cardiovascular events in patients with SVT was 7 times higher (95% CI: 4.7-10.5) than in patients with DVT or PE and nearly 16 times higher (95% CI: 9.3-26.8) than in the general population.
The authors noted that “physicians should be cognizant of these risks” and suggested that treatment options, such as the avoidance or use of certain anticoagulants, should be personalized for each patient.
1. Søgaard KK, Adelborg K, Darvalics B, et al. Risk of bleeding and arterial cardiovascular events in patients with splanchnic vein thrombosis in Denmark: a population-based cohort study [published online October 1, 2018]. Lancet Haematol. doi: 10.1016/S2352-3026(18)30133-9