Korean Circ J.  2021 Sep;51(9):766-780. 10.4070/kcj.2021.0213.

Heart Failure Is Associated with Increased Risk of Long-Term Venous Thromboembolism

• Xu T
• Huang Y
• Liu Z
• Bai Y
• Ma Z
• Cai X
• Zhang Y
• Zhang J

• KMID: 2519837
• DOI: http://doi.org/10.4070/kcj.2021.0213

Abstract

Background and Objectives
Venous thromboembolism (VTE), consisting of deep vein thrombosis (DVT) and pulmonary embolism (PE), is highly prevalent in in-hospital HF patients and contributes to worse prognoses. However, the risk of VTE in out-patients with HF in long-term period is controversial. This study aimed to evaluate the associations between HF and the risk of VTE in a long-term follow-up duration.
Methods
We searched for studies investigating the risk of VTE, PE, and DVT in patients with HF before April 15, 2020, in PubMed, MEDLINE, and Embase databases. Cohort studies and post hoc analysis of RCTs were eligible for inclusion if they reported relative risk of VTE, DVT or PE in patients with HF in more than 3-month follow-up period.
Results
We identified 31 studies that enrolled over 530,641 HF patients. Overall, patients with HF were associated with an increased risk of VTE (risk ratio [RR]=1.57, 95% confidence interval [CI]=1.34–1.84) and PE (RR=2.00, 95% CI=1.38–2.89). However, the risk of DVT was not significantly increased in HF patients (RR=1.33, 95% CI=0.67–2.63). Subgroup analysis showed that patients with chronic HF (RR=1.54, 95% CI=1.32–1.80) had a higher risk of VTE than those with acute HF (RR=0.95, 95% CI=0.68–1.32).
Conclusions
In conclusion, HF was an independent risk for VTE and PE but not DVT in a longterm follow-up period. Patients with chronic HF were prone to suffer from VTE than acute HF.

Keyword

Heart failure; Venous thromboembolism; Risk ratio

Figure

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  Figure 1 Flow of papers through review.DVT = deep vein thrombosis; HF = heart failure; PE = pulmonary embolism; VTE = venous thromboembolism.

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  Figure 2 Risk of VTE, PE and DVT in patients with HF.CI = confidence interval; DVT = deep vein thrombosis; HF = heart failure; PE = pulmonary embolism; RR = risk ratio; SE = standard error; VTE = venous thromboembolism.

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  Figure 3 Risk of VTE in patients with acute HF and chronic HF.CI = confidence interval; HF = heart failure; SE = standard error; VTE = venous thromboembolism.

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