serval:BIB_A42C877CEFEB
Association between smoking and recurrence of venous thromboembolism and bleeding in elderly patients with past acute venous thromboembolism.
10.1016/j.thromres.2015.11.034
000368811200013
26688323
Carruzzo
P.
author
Méan
M.
author
Limacher
A.
author
Aujesky
D.
author
Cornuz
J.
author
Clair
C.
author
article
2016
Thrombosis Research
1879-2472
0049-3848
journal
138
74-79
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.
Acute Disease
Aged
Aged, 80 and over
Female
Hemorrhage/etiology
Hemorrhage/pathology
Humans
Male
Prospective Studies
Recurrence
Risk Factors
Smoking/adverse effects
Venous Thromboembolism/etiology
Venous Thromboembolism/pathology
eng
60_published
true
peer-reviewed
Publication types: Journal Article ; Multicenter Study
Publication Status: ppublish
University of Lausanne
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