Researchers identified patterns related to age and sex in outcomes with cerebral venous thrombosis (CVT) among individuals in a nationwide cohort study in Denmark. The results of the study were published in Blood Advances.
The researchers explained that CVT disproportionately impacts younger and middle-aged women, in comparison with older women. They had an aim of expanding what is known regarding the clinical course of CVT overall and across age groups.
The research team performed a population-based analysis of long-term risks of thromboembolic events, bleeding rates, and mortality based on an examination of individuals’ records from Danish registries. Among people in this registry were 653 patients with an initial, primary, inpatient CVT diagnosis between 1996 and 2018.
Characteristics and outcomes in these patients were compared with those of 65,300 individuals from the general population, with comparisons matched by age, sex, and calendar year. Analyses involving groupings by sex and by age, with age groups divided into categories of 18 to 54 years and 55 years or older.
The median age in both the CVT or general-population cohorts was 41 years, and the majority (67%) of individuals were female in either cohort. First-time CVT diagnosis occurred with an incidence rate overall of 1.24 per 100,000 person-years (95% CI, 1.17-1.31). Among women, the rates were 1.73 (95% CI, 1.59-1.88) in the younger population and 1.15 (95% CI, 1.01-1.32) in the older population. Among men, the rates were 0.75 (95% CI, 0.66-0.85) in the younger group and 1.37 (95% CI, 1.20-1.56) in the older group.
CVT recurrence was reported with a total of 37 hospitalizations occurring at least 90 days after the index date, and 70% of these were reported in younger women. Overall, CVT was associated with greater risks of venous thromboembolism (VTE) in other sites, ischemic stroke, major bleeding, and death.
The researchers reported that the 10-year risks of VTE in other sites were 2.2% in younger women with CVT and 0.4% in the matched cohort (adjusted hazard ratio [aHR], 6.55; 95% CI, 2.79-15.35). The 10-year risk of all-cause mortality was 5.3% in younger women with CVT, compared with 0.8% in the matched cohort (aHR, 5.99; 95% CI, 3.45-10.38).
In older women, the 10-year risks of ischemic stroke were 12.8% in those with a CVD diagnosis and 3.1% in the matched cohort (aHR, 6.63; 95% CI, 3.32-13.23). In older women, the 10-year risks of major bleeding were 11.1% among those with a CVD diagnosis and 4.6% in the matched cohort (aHR, 3.97; 95% CI, 1.93-8.18). Among older women, for all-cause mortality, the 10-year risk was 43.1% in those with a CVD diagnosis, compared with 26.7% in the matched cohort (aHR, 2.82; 95% CI, 1.96-4.05).
“In conclusion, patients with CVT were at increased risk of recurrent CVT, VTE in other sites, ischemic stroke, major bleeding, and mortality, but the magnitude of these risks clearly depended on sex and age at time of diagnosis,” the researchers wrote in their report.
Skajaa N, Vandenbroucke JP, Ziegler Simonsen C, Toft Sørensen H, Adelborg K. Thromboembolic events, bleeding, and mortality in patients with cerebral venous thrombosis: a nationwide cohort study. Blood Adv. Published online September 16, 2022. doi:10.1182/bloodadvances.2022008622