Venous thromboembolism and risk of idiopathic interstitial pneumonia: a nationwide study

TY - JOUR

T1 - Venous thromboembolism and risk of idiopathic interstitial pneumonia

T2 - a nationwide study

AU - Sode, Birgitte F

AU - Dahl, Morten

AU - Nielsen, Sune F

AU - Nordestgaard, Børge G

PY - 2010/5/15

Y1 - 2010/5/15

N2 - Rationale: Idiopathic interstitial pneumonia is characterized by pulmonary fibrosis and high mortality. Objectives: We examined the association between ever-diagnosed venous thromboembolism and risk of incident idiopathic interstitial pneumonia. Venous thromboembolism was taken as a proxy for a procoagulant state in an individual. Methods: We conducted a study of the entire Danish population from 1980 through 2007, comprising 7.4 million individuals. Incident idiopathic interstitial pneumonia, ever-diagnosed venous thromboembolism, and use of prescription anticoagulants were drawn from national Danish registries. Measurements and Main Results: Age-standardized incidence rates per 10,000 person-years for idiopathic interstitial pneumonia were higher amongthose ever diagnosed with venous thromboembolism (1.8; n = 158,676), pulmonary embolism (2.8; n = 70,586), and deep venous thrombosis only (1.2; n = 88,090), than among control subjects (0.8; n = 7,260,278). Multivariate-adjusted hazard ratios for idiopathic interstitial pneumonia were 1.8 (95% confidence interval [CI], 1.7-1.9) in those ever diagnosed with venous thromboembolism, 2.4 (95% CI, 2.3-2.6) in those ever diagnosed with pulmonary embolism, and 1.3 (95% CI, 1.2-1.4) in those ever diagnosed with deep venous thrombosis only, compared with control subjects. Corresponding hazard ratios in those ever diagnosed with venous thromboembolism stratified in those ever and never treated with anticoagulants were 1.4 (95%CI, 1.2-1.6) and 2.8 (95% CI, 2.4-3.1) (venous thromboembolism X anticoagulation use interaction on idiopathic interstitial pneumonia outcome: P = 1.5 × 10-10). Conclusions: In the general population, ever-diagnosed venous thromboembolism was associated with idiopathic interstitial pneumonia, particularly among those never treated with anticoagulants.

AB - Rationale: Idiopathic interstitial pneumonia is characterized by pulmonary fibrosis and high mortality. Objectives: We examined the association between ever-diagnosed venous thromboembolism and risk of incident idiopathic interstitial pneumonia. Venous thromboembolism was taken as a proxy for a procoagulant state in an individual. Methods: We conducted a study of the entire Danish population from 1980 through 2007, comprising 7.4 million individuals. Incident idiopathic interstitial pneumonia, ever-diagnosed venous thromboembolism, and use of prescription anticoagulants were drawn from national Danish registries. Measurements and Main Results: Age-standardized incidence rates per 10,000 person-years for idiopathic interstitial pneumonia were higher amongthose ever diagnosed with venous thromboembolism (1.8; n = 158,676), pulmonary embolism (2.8; n = 70,586), and deep venous thrombosis only (1.2; n = 88,090), than among control subjects (0.8; n = 7,260,278). Multivariate-adjusted hazard ratios for idiopathic interstitial pneumonia were 1.8 (95% confidence interval [CI], 1.7-1.9) in those ever diagnosed with venous thromboembolism, 2.4 (95% CI, 2.3-2.6) in those ever diagnosed with pulmonary embolism, and 1.3 (95% CI, 1.2-1.4) in those ever diagnosed with deep venous thrombosis only, compared with control subjects. Corresponding hazard ratios in those ever diagnosed with venous thromboembolism stratified in those ever and never treated with anticoagulants were 1.4 (95%CI, 1.2-1.6) and 2.8 (95% CI, 2.4-3.1) (venous thromboembolism X anticoagulation use interaction on idiopathic interstitial pneumonia outcome: P = 1.5 × 10-10). Conclusions: In the general population, ever-diagnosed venous thromboembolism was associated with idiopathic interstitial pneumonia, particularly among those never treated with anticoagulants.

KW - Adult

KW - Aged

KW - Anticoagulants

KW - Case-Control Studies

KW - Denmark

KW - Female

KW - Humans

KW - Idiopathic Interstitial Pneumonias

KW - Lung Diseases, Interstitial

KW - Male

KW - Middle Aged

KW - Population Surveillance

KW - Proportional Hazards Models

KW - Pulmonary Embolism

KW - Registries

KW - Risk Assessment

KW - Venous Thromboembolism

KW - Young Adult

U2 - 10.1164/rccm.200912-1951OC

DO - 10.1164/rccm.200912-1951OC

M3 - Journal article

C2 - 20167844

SN - 1073-449X

VL - 181

SP - 1085

EP - 1092

JO - American Journal of Respiratory and Critical Care Medicine

JF - American Journal of Respiratory and Critical Care Medicine

IS - 10

ER -