Risk factors of arterial thrombotic events after unprovoked venous thromboembolism, and after cancer associated venous thromboembolism: A prospective cohort study
Abstract
Introduction:The increased risk of arterial thrombotic (ATE) after VTE, particularly when they are unprovoked or cancer-associated has been established. However, the risk factors of ATE after these VTE remain unclear.
Material and Methods: Using cause-specific hazard regression models, we determined risk factors of ATE (myocardial infarction, ischemic stroke, acute limb ischemia, digestive tract ischemia, or renal ischemia) in 2242 patients with unprovoked VTE and in 914 patients with cancer-associated VTE from a multi-center prospective cohort.
Results: Of patients with unprovoked-VTE, 174 developed ATE (7.8%, incidence: 1.26 per 100 patient-years) during follow-up (median: 68 months). Among patients with cancerassociated VTE, 57 developed ATE (6.2%, incidence: 1.98 per 100 patient-years) during follow-up (median: 30 months). After multivariable analysis, the identified risk factors of ATE in patients with unprovoked-VTE were age > 65 years (vs.< 50 years, HR 2.59, 95% CI:
1.56-4.29), past history of symptomatic atherosclerosis (HR 2.11, 95% CI: 1.40-3.19), and treatment with low molecule weight heparin (vs. vitamin K antagonists, HR: 2.26, 95% CI:
1.13-4.52). In patients with cancer-associated VTE, the identified risk factors of ATE were: past history of symptomatic atherosclerosis (HR: 3.13, 95% CI: 1.72-5.67), and ongoing anticoagulation at the diagnosis of VTE (HR: 2.77, 95% CI: 1.07-7.22).
Conclusions:The risk of ATE after unprovoked VTE and after cancer-associated VTE, is determined by some classic cardiovascular risk factors and is influenced by anticoagulant treatment introduced for VTE, as well as the presence or absence of ongoing anticoagulation at the diagnosis of VTE.
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BibTeX
@article{noumegni2026risk,
title = {{Risk factors of arterial thrombotic events after unprovoked venous thromboembolism, and after cancer associated venous thromboembolism: A prospective cohort study}},
author = {Steve Raoul Noumegni and Romain Didier and Vincent Mansourati and Cécile Tromeur and Emmanuelle Le Moigne and Clément Hoffmann and Bahaa Nasr and Jean-Christophe Gentric and Marie Guegan and Elise Poulhazan and Karine Lacut and Luc Bressollette and Raphael Le Mao and Francis Couturaud},
journal = {Thrombosis Research},
year = {2026},
month = sep,
doi = {10.1016/j.thromres.2022.04.016},
url = {https://hal.science/hal-05753616v1},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Risk factors of arterial thrombotic events after unprovoked venous thromboembolism, and after cancer associated venous thromboembolism: A prospective cohort study
AU - Steve Raoul Noumegni
AU - Romain Didier
AU - Vincent Mansourati
AU - Cécile Tromeur
AU - Emmanuelle Le Moigne
AU - Clément Hoffmann
AU - Bahaa Nasr
AU - Jean-Christophe Gentric
AU - Marie Guegan
AU - Elise Poulhazan
AU - Karine Lacut
AU - Luc Bressollette
AU - Raphael Le Mao
AU - Francis Couturaud
PY - 2026
DA - 2026/09/17
JO - Thrombosis Research
DO - 10.1016/j.thromres.2022.04.016
UR - https://hal.science/hal-05753616v1
AB - Introduction:The increased risk of arterial thrombotic (ATE) after VTE, particularly when they are unprovoked or cancer-associated has been established. However, the risk factors of ATE after these VTE remain unclear. Material and Methods: Using cause-specific hazard regression models, we determined risk factors of ATE (myocardial infarction, ischemic stroke, acute limb ischemia, digestive tract ischemia, or renal ischemia) in 2242 patients with unprovoked VTE and in 914 patients with cancer-associated VTE from a multi-center prospective cohort. Results: Of patients with unprovoked-VTE, 174 developed ATE (7.8%, incidence: 1.26 per 100 patient-years) during follow-up (median: 68 months). Among patients with cancerassociated VTE, 57 developed ATE (6.2%, incidence: 1.98 per 100 patient-years) during follow-up (median: 30 months). After multivariable analysis, the identified risk factors of ATE in patients with unprovoked-VTE were age > 65 years (vs.< 50 years, HR 2.59, 95% CI: 1.56-4.29), past history of symptomatic atherosclerosis (HR 2.11, 95% CI: 1.40-3.19), and treatment with low molecule weight heparin (vs. vitamin K antagonists, HR: 2.26, 95% CI: 1.13-4.52). In patients with cancer-associated VTE, the identified risk factors of ATE were: past history of symptomatic atherosclerosis (HR: 3.13, 95% CI: 1.72-5.67), and ongoing anticoagulation at the diagnosis of VTE (HR: 2.77, 95% CI: 1.07-7.22). Conclusions:The risk of ATE after unprovoked VTE and after cancer-associated VTE, is determined by some classic cardiovascular risk factors and is influenced by anticoagulant treatment introduced for VTE, as well as the presence or absence of ongoing anticoagulation at the diagnosis of VTE.
SN - 0049-3848
SN - 1879-2472
ER -