Multimorbidity is associated with risk of incident venous thromboembolism – A nationwide proof-of-concept study
Background: Multimorbidity, i.e. two or more non-communicable diseases (NCDs), has been associated with venous thromboembolism (VTE), but whether multimorbidity is a predictor for incident VTE is unknown. Aims: To examine the associations between multimorbidity and its severity with risk of incident...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-03-01
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| Series: | Thrombosis Update |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S266657272500001X |
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| author | Jonatan Ahrén MirNabi Pirouzifard Björn Holmquist Jan Sundquist Kristina Sundquist Bengt Zöller |
| author_facet | Jonatan Ahrén MirNabi Pirouzifard Björn Holmquist Jan Sundquist Kristina Sundquist Bengt Zöller |
| author_sort | Jonatan Ahrén |
| collection | DOAJ |
| description | Background: Multimorbidity, i.e. two or more non-communicable diseases (NCDs), has been associated with venous thromboembolism (VTE), but whether multimorbidity is a predictor for incident VTE is unknown. Aims: To examine the associations between multimorbidity and its severity with risk of incident VTE, and examine the association between nine different disease clusters and incident VTE. Methods: A cohort study using landmark analysis of 2,694,442 individuals. Swedish national registers were linked and three landmarks (L1, L2, L3), i.e. baselines, were created with 14-, nine- and four-year follow-up times, respectively. Two or more NCDs defined multimorbidity and ≥5 marked multimorbidity severity. A hazard ratio (HR) with 95 % confidence interval (CI) for VTE was calculated and adjusted for sex, education and year of birth. Death and emigration were treated as competing events. Results: A total of 2,694,442 individuals were included. Multimorbidity was associated with incident VTE in all three analyzed landmarks: adjusted HR for VTE was 2.47 (95%CI 2.24–2.72) for L1, HR was 2.23 (95%CI 2.11–2.36) for L2, and HR was 2.16 (95%CI 2.03–2.29) for L3. HR increased with multimorbidity severity. For instance, HRs for multimorbidity with five or more NCDs was 4.29 (95%CI 2.53–7.28) in L1 analysis, 4.45 (95%CI 3.64–5.45) in L2 analysis and 4.83 (95%CI 4.20–5.55) in L3 analysis. Moreover, seven of nine different multimorbidity disease clusters were predictors for VTE. Conclusion: This study demonstrated proof-of-concept that multimorbidity is a novel dose-graded predictor for VTE. Further studies will determine the usefulness of multimorbidity for VTE prediction in different clinical settings. |
| format | Article |
| id | doaj-art-4d18ef5f1f3f4c059cb067300eab4340 |
| institution | Kabale University |
| issn | 2666-5727 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Thrombosis Update |
| spelling | doaj-art-4d18ef5f1f3f4c059cb067300eab43402025-02-05T04:32:41ZengElsevierThrombosis Update2666-57272025-03-0118100198Multimorbidity is associated with risk of incident venous thromboembolism – A nationwide proof-of-concept studyJonatan Ahrén0MirNabi Pirouzifard1Björn Holmquist2Jan Sundquist3Kristina Sundquist4Bengt Zöller5Center for Primary Health Care Research, Lund University/Region Skåne, 205 02, Malmö, Sweden; University Clinic Primary Care Skåne, Region Skåne, Sweden; Corresponding author. Center for Primary Health Care Research, CRC, Building 28, Floor 11, Jan Waldenströms gata 35, Skåne University Hospital, S-205 02, Malmö, Sweden.Center for Primary Health Care Research, Lund University/Region Skåne, 205 02, Malmö, Sweden; University Clinic Primary Care Skåne, Region Skåne, SwedenDepartment of Statistics, Lund University, 220 07, Lund, SwedenCenter for Primary Health Care Research, Lund University/Region Skåne, 205 02, Malmö, Sweden; University Clinic Primary Care Skåne, Region Skåne, SwedenCenter for Primary Health Care Research, Lund University/Region Skåne, 205 02, Malmö, Sweden; University Clinic Primary Care Skåne, Region Skåne, SwedenCenter for Primary Health Care Research, Lund University/Region Skåne, 205 02, Malmö, Sweden; University Clinic Primary Care Skåne, Region Skåne, SwedenBackground: Multimorbidity, i.e. two or more non-communicable diseases (NCDs), has been associated with venous thromboembolism (VTE), but whether multimorbidity is a predictor for incident VTE is unknown. Aims: To examine the associations between multimorbidity and its severity with risk of incident VTE, and examine the association between nine different disease clusters and incident VTE. Methods: A cohort study using landmark analysis of 2,694,442 individuals. Swedish national registers were linked and three landmarks (L1, L2, L3), i.e. baselines, were created with 14-, nine- and four-year follow-up times, respectively. Two or more NCDs defined multimorbidity and ≥5 marked multimorbidity severity. A hazard ratio (HR) with 95 % confidence interval (CI) for VTE was calculated and adjusted for sex, education and year of birth. Death and emigration were treated as competing events. Results: A total of 2,694,442 individuals were included. Multimorbidity was associated with incident VTE in all three analyzed landmarks: adjusted HR for VTE was 2.47 (95%CI 2.24–2.72) for L1, HR was 2.23 (95%CI 2.11–2.36) for L2, and HR was 2.16 (95%CI 2.03–2.29) for L3. HR increased with multimorbidity severity. For instance, HRs for multimorbidity with five or more NCDs was 4.29 (95%CI 2.53–7.28) in L1 analysis, 4.45 (95%CI 3.64–5.45) in L2 analysis and 4.83 (95%CI 4.20–5.55) in L3 analysis. Moreover, seven of nine different multimorbidity disease clusters were predictors for VTE. Conclusion: This study demonstrated proof-of-concept that multimorbidity is a novel dose-graded predictor for VTE. Further studies will determine the usefulness of multimorbidity for VTE prediction in different clinical settings.http://www.sciencedirect.com/science/article/pii/S266657272500001XEpidemiologyMedicineMultimorbidityPublic healthVenous thromboembolism |
| spellingShingle | Jonatan Ahrén MirNabi Pirouzifard Björn Holmquist Jan Sundquist Kristina Sundquist Bengt Zöller Multimorbidity is associated with risk of incident venous thromboembolism – A nationwide proof-of-concept study Thrombosis Update Epidemiology Medicine Multimorbidity Public health Venous thromboembolism |
| title | Multimorbidity is associated with risk of incident venous thromboembolism – A nationwide proof-of-concept study |
| title_full | Multimorbidity is associated with risk of incident venous thromboembolism – A nationwide proof-of-concept study |
| title_fullStr | Multimorbidity is associated with risk of incident venous thromboembolism – A nationwide proof-of-concept study |
| title_full_unstemmed | Multimorbidity is associated with risk of incident venous thromboembolism – A nationwide proof-of-concept study |
| title_short | Multimorbidity is associated with risk of incident venous thromboembolism – A nationwide proof-of-concept study |
| title_sort | multimorbidity is associated with risk of incident venous thromboembolism a nationwide proof of concept study |
| topic | Epidemiology Medicine Multimorbidity Public health Venous thromboembolism |
| url | http://www.sciencedirect.com/science/article/pii/S266657272500001X |
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