Association between smoking and recurrence of venous thromboembolism and bleeding in elderly patients with past acute venous thromboembolism.

Carruzzo, Philippe; Méan, Marie; Limacher, Andreas; Aujesky, Drahomir; Cornuz, Jacques; Clair, Carole (2016). Association between smoking and recurrence of venous thromboembolism and bleeding in elderly patients with past acute venous thromboembolism. Thrombosis research, 138, pp. 74-79. Elsevier 10.1016/j.thromres.2015.11.034

[img] Text
Carruzzo ThrombRes 2016.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (225kB) | Request a copy

BACKGROUND While the association between smoking and arterial cardiovascular events has been well established, the association between smoking and venous thromboembolism (VTE) remains controversial. OBJECTIVES To assess the association between smoking and the risk of recurrent VTE and bleeding in patients who have experienced acute VTE. PATIENTS/METHODS This study is part of a prospective Swiss multicenter cohort that included patients aged ≥65years with acute VTE. Three groups were defined according to smoking status: never, former and current smokers. The primary outcome was the time to a first symptomatic, objectively confirmed VTE recurrence. Secondary outcomes were the time to a first major and clinically relevant non-major bleeding. Associations between smoking status and outcomes were analysed using proportional hazard models for the subdistribution of a competing risk of death. RESULTS Among 988 analysed patients, 509 (52%) had never smoked, 403 (41%) were former smokers, and 76 (8%) current smokers. After a median follow-up of 29.6months, we observed a VTE recurrence rate of 4.9 (95% confidence interval [CI] 3.7-6.4) per 100 patient-years for never smokers, 6.6 (95% CI 5.1-8.6) for former smokers, and 5.2 (95% CI 2.6-10.5) for current smokers. Compared to never smokers, we found no association between current smoking and VTE recurrence (adjusted sub-hazard ratio [SHR] 1.05, 95% CI 0.49-2.28), major bleeding (adjusted SHR 0.59, 95% CI 0.25-1.39), and clinically relevant non-major bleeding (adjusted SHR 1.21, 95% CI 0.73-2.02). CONCLUSIONS In this multicentre prospective cohort study, we found no association between smoking status and VTE recurrence or bleeding in elderly patients with VTE.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine
04 Faculty of Medicine > Pre-clinic Human Medicine > CTU Bern
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine

UniBE Contributor:

Méan Pascual, Marie; Limacher, Andreas and Aujesky, Drahomir

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0049-3848

Publisher:

Elsevier

Language:

English

Submitter:

Jacques Donzé

Date Deposited:

15 Feb 2017 12:58

Last Modified:

23 Feb 2017 16:33

Publisher DOI:

10.1016/j.thromres.2015.11.034

PubMed ID:

26688323

Uncontrolled Keywords:

Aged; Hemorrhage; Recurrence; Smoking; Venous thromboembolism

BORIS DOI:

10.7892/boris.94661

URI:

https://boris.unibe.ch/id/eprint/94661

Actions (login required)

Edit item Edit item
Provide Feedback