VTE did not raise later arterial events
In this emergency-care cohort, venous clots were not linked to higher future arterial heart or stroke events, but were linked to higher overall death.
*Retrospective cohort study; Level 2b (OCEBM).

Citation

Lonnberg F, Siddiqui AJ. Risk of cardiovascular events in patients diagnosed with venous thromboembolism. The American Journal of Medicine. 2026;139:181–188. doi:10.1016/j.amjmed.2025.08.035

Background

Prior studies disagree on whether venous blood clots increase later arterial events (such as heart attack or ischemic stroke) or whether shared risk factors explain the association. This study examined this question in a large emergency-care population.

Patients

Adults (≥18 years) seen at five emergency departments in Stockholm (2016–2017). Excluded: any prior or same-visit arterial cardiovascular event.

Intervention

Diagnosis of deep vein thrombosis or pulmonary embolism linked to the emergency visit.

Control

All other emergency-department patients without venous clot diagnosis.

Outcome

Primary: composite arterial cardiovascular event (heart attack, angina, ischemic stroke, heart failure, peripheral artery disease). Secondary: cardiovascular death; all-cause death.

Follow-up Period

Mean 1.2 years for arterial events; 2.1 years for mortality.

Results

Outcome Timepoint Group vs control Adjusted hazard ratio (95% CI)
Arterial cardiovascular event (primary) 30 days Pulmonary embolism 0.46 (0.22–0.96)
Arterial cardiovascular event (primary) 1 year Deep vein thrombosis 0.76 (0.58–0.99)
Arterial cardiovascular event (primary) Full follow-up Deep vein thrombosis 0.74 (0.59–0.94)
All-cause death Full follow-up Deep vein thrombosis 1.64 (1.48–1.82)
All-cause death Full follow-up Pulmonary embolism 2.37 (2.14–2.63)
Models adjusted for age, sex, and key long-term conditions. Event rates for the composite arterial outcome were low (about 1.6% in controls; 1.9% in deep vein thrombosis; 2.5% in pulmonary embolism).

Limitations

Observational design with possible unmeasured differences (for example smoking, body weight, and whether the clot was provoked). Short follow-up for arterial events and use of a mixed composite outcome may limit patient-relevant interpretation; statistically lower hazard did not clearly translate into lower absolute event rates.

Funding

No sponsorship or funding reported.

Clinical Application

After diagnosing deep vein thrombosis or pulmonary embolism, prioritize mortality-risk drivers and standard risk-factor control; do not assume the clot itself increases later arterial event risk.