Study Finds a Link Between Heart Failure and Long-Term Risk of VTE

In this study, researchers assessed 31 studies consisting of over 530,641 HF patients with data obtained studies investigating the risk of VTE, PE, and DVT in patients with HF before April 15, 2020, in PubMed, MEDLINE, and Embase databases investigating the risk of VTE, PE, and DVT in patients with HF before April 15, 2020. Eligibility criteria was defined as cohort studies and post hoc analysis of randomized controlled trials (RCTs) if they reported relative risk of VTE, DVT or PE in patients with HF in more than 3-month follow-up period.

According to the results, 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 researchers noted, the risk of DVT was not significantly increased in HF patients (RR=1.33, 95% CI=0.67–2.63). A subsequent subgroup analysis demonstrated 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).

The study had several limitations that the researchers reported. Firstly, the study did not assess the impact of severities and types of chronic HF on VTE, and did not provide added insights into the risk of VTE in sub-group patients. Secondly, because there were still few studies about the risk of DVT in patients with HF, their analysis may have underestimate the risk of DVT in HF patients. Thirdly, they noted, the analysis only included four studies about acute HF and only one reported the risk of VTE in patients with new-onset HF. “Thus, we lack enough data of acute HF patients, especially those new-onset HF patients, to distinguish whether acute HF or chronic HF would have a noticeable effect on the VTE risk.”

Fourth, the study displayed marked heterogeneity among most analyses due to such reasons as different follow-up durations, types of diseases and complications, population.  Fifth, we was not able to show the associations of activity level and the risks of VTE, PE, and DVT, since the data of included studies was limited. Finally, most of our studies were retrospective studies, and prospective studies with high quality such as RCTs are needed to testify our results.

“In conclusion, HF was an independent risk for VTE and PE but not DVT in the long-term follow-up period. Patients with chronic HF were prone to have a higher risk of VTE,” the researchers wrote.

“Further designated and prospective studies are needed for our better understandings of impacts of HF on the risk of VTE, PE and, DVT. RCTs about anticoagulation therapy in HF patients to prevent VTE, PE, and DVT are also needed for better management of HF patients.”