Venous Thromboembolic Events After Cerebral Vein Thrombosis
Open Access
- 1 September 2010
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Stroke
- Vol. 41 (9), 1901-1906
- https://doi.org/10.1161/strokeaha.110.581223
Abstract
Background and Purpose— After cerebral vein and dural sinus thrombosis (CVT), there is an increased risk of further venous thromboembolic events (VTEs). Time to a second cerebral or systemic venous thrombotic event and risk factors for recurrence have not been investigated in large prospective studies. Methods— We used the International Study on Cerebral Vein and Dural sinus Thrombosis, which included 624 patients with CVT followed up for a median of 13.9 months. Outcome measures included all symptomatic VTEs and CVT recurrence. Potential predictors of recurrence, including demographic characteristics, imaging features, thrombophilic abnormalities, other risk factors for CVT, and anticoagulation, were analyzed by Cox survival analysis. Results— Of the 624 included patients, 36 (5.8%) had at least 1 venous thromboembolic event. The rate of VTEs after the initial CVT was 4.1 per 100 person-years. Of all VTEs, 63.2% (n=24) occurred within the first year. Fourteen patients (2.2%) had an episode of recurrent CVT and the rate of recurrence was 1.5 per 100 person-years. Nine (64.3%) of these CVT recurrences occurred within the first year. Male gender (hazard ratios=2.6; 95% CI, 1.4 to 5.1; P =0.004) and polycythemia/thrombocythemia (hazard ratios=4.4; 95% CI, 1.6 to 12.7; P =0.005) were the only factors associated with a significant higher risk of VTEs in multivariate survival analysis. Conclusions— The risk of recurrence of CVT is low but is moderate for other VTEs. Recurrence of venous thrombosis after CVT is more frequent among men and in patients with polycythemia/thrombocythemia.This publication has 24 references indexed in Scilit:
- Risk factors for recurrent venous thromboembolism in the European collaborative paediatric database on cerebral venous thrombosis: a multicentre cohort studyThe Lancet Neurology, 2007
- Cerebral venous thrombosis: an updateThe Lancet Neurology, 2007
- Risk of thromboembolism after cerebral venous thrombosisEuropean Journal of Neurology, 2006
- Thrombosis of the Cerebral Veins and SinusesThe New England Journal of Medicine, 2005
- Hormones and pregnancy: thromboembolic risks for womenBritish Journal of Haematology, 2004
- Influence of Recanalization on Outcome in Dural Sinus ThrombosisStroke, 2004
- Risk of recurrence of cerebral venous and sinus thrombosis during subsequent pregnancy and puerperiumJournal of Neurology, Neurosurgery & Psychiatry, 2003
- Recanalisation of cerebral venous thrombosisJournal of Neurology, Neurosurgery & Psychiatry, 2003
- Long-Term Prognosis of Cerebral Vein and Dural Sinus ThrombosisCerebrovascular Diseases, 2002
- Nonparametric Estimation from Incomplete ObservationsJournal of the American Statistical Association, 1958