Abstract 3758: Long-term Recurrence of Venous Thrombotic Events After Cerebral Vein Thrombosis
Background. It is assumed that cerebral venous thrombosis (CVT) implies a lower risk of death and recurrence at short- and mid-term follow-up; however, few information exist on risk factors and outcome of thrombotic venous recurrence after CVT in the long run. We aimed to describe the 20-year recurrence of intra and extracranial venous thrombotic events after an index CVT in a large cohort.
Methods. Among 412 consecutive patients, we analyzed 336 (81.6%) cases (82,7% women, mean age: 30.9 years, range: 14 to 83 years) registered from 1986 to 2010 in a third-level referral center of Mexico City, for whom complete information of recurrent events was available and who survived the acute phase of CVT.
Results. In a median follow-up of 28 months (range 2 to 288 months), the recurrence rate of either systemic or intracranial venous thrombotic events was 6.8% (n=23): 2.7% of recurrent CVT, 3% lower-limb thrombosis and 1.1% pulmonary embolism). Recurrent venous events occurred by a median of 5 months (range: 1 to 113 months), with 78% cases recurring in the following year after index CVT. Nonetheless, recurrent CVT occurred within 5 months in 78% cases. None of the recurrent CVT events caused death, but 50% of pulmonary embolisms were mortal. In a Cox proportional hazards model adjusted for multiple confounders, baseline factors associated with an increased risk of recurrent intra or extracranial venous thrombosis were thrombosis of jugular veins [hazard ratio (HR): 5.13, 95% confidence interval (CI): 1.39-18.9], diagnosis of anti-phospholipid syndrome (HR: 2.67, 95% CI: 1.01-7.07), mechanical ventilation (HR: 2.07, 95% CI: 1.08-3.93), and alcoholism (HR: 3.44, 95% CI: 1.12-10.58).
Conclusion. Most venous recurrent events occur in the following year after index CVT. Recurrent CVT is not associated with a high mortality, but extracranial venous thromboembolisms can be fatal. This study is the largest to date on this topic.
- © 2012 by American Heart Association, Inc.