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Blood, 20 August 2009, Vol. 114, No. 8, pp. 1484-1488. Prepublished online as a Blood First Edition Paper on June 23, 2009; DOI 10.1182/blood-2009-05-220491. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2009-05-220491v1 114/8/1484    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Google Scholar Articles by Klok, F. A. Articles by Huisman, M. V. PubMed PubMed Citation Articles by Klok, F. A. Articles by Huisman, M. V. Related Collections Free Research Articles Thrombosis and Hemostasis Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Risk of arterial cardiovascular events in patients after pulmonary embolism Frederikus A. Klok1, Inge C.M. Mos1, Lisette Broek1, Jouke T. Tamsma1, Frits R. Rosendaal2, Albert de Roos3, and Menno V. Huisman1 1 Section of Vascular Medicine, Department of General Internal Medicine-Endocrinology, 2 Department of Clinical Epidemiology and Department of Thrombosis and Hemostasis, and 3 Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands Studies have reported inconsistent evidence for an association between venous thrombosis and arterial cardiovascular events. We further studied the association between both diseases by comparing the occurrence of cardiovascular events in patients diagnosed with acute pulmonary embolism (PE) contrasted to patients with comparable baseline risk characteristics (patients in whom PE was clinically suspected but ruled out). Included were 259 patients with provoked PE, 95 patients with unprovoked PE, and 334 control patients without PE. Patients diagnosed with PE were treated with vitamin K antagonists for 6 months. Median follow-up was 4.2 years. Sixty-three arterial cardiovascular events were registered (incidence, 5.1/100 patient-years). Adjusted hazard ratio was not different between patients with all-cause PE and control patients (1.39, 95% confidence interval [CI], 0.83-2.3) but increased for patients with unprovoked PE versus both patients with provoked PE and control patients without PE (2.18; 95% CI, 1.1-4.5; and 2.62; 95% CI, 1.4-4.9, respectively). This effect was confirmed after redefining the study start date to the moment the vitamin K antagonists were discontinued. Our study underlines the association between unprovoked venous thrombosis and arterial cardiovascular events; however, risk differences between patients with provoked PE and patients in whom PE was clinically suspected but ruled out could not be demonstrated. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: Is Venous Thromboembolism a Risk Factor for Arterial Events? Journal Watch Oncology and Hematology, September 22, 2009; 2009(922): 4 - 4. [Full Text]

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