Abstract
Background Cerebral venous thrombosis (CVT) is a rare manifestation of stroke and venous thromboembolism
(VTE), compared with deep vein thrombosis (DVT) and pulmonary embolism (PE). We examined
whether CVT was associated with adverse cardiovascular events.
Methods A Danish cohort study with adult patients diagnosed with CVT (N = 1,015) between 1997 and 2017. We matched 10 patients with VTE (DVT and PE) to each
patient with CVT for age, sex, and diagnosis year. We also matched 10 individuals
from the general population to each patient with CVT. We computed cumulative incidence
and estimated hazard ratios (HRs) with 95% confidence intervals (95% CIs) at 5 years
for major bleeding, intracranial bleeding, ischemic stroke, and cardiovascular events.
Death was examined separately.
Results Major bleeding risks were 1.2% for CVT and 0.7% for VTE at 6 months; these risks
increased to 2.7% and 2.6%, respectively, at 5 years. Although rare, intracranial
bleeding risks were markedly higher for CVT (2.9%) than for VTE (0.4%) at 5 years
(HR = 8.9, 95% CI: 5.3–15.1). Incidences of ischemic stroke were 5.9% for CVT and
0.3% for VTE, at 6 months; and 10.0% and 1.4%, respectively, at 5 years (HR = 9.5,
95% CI: 7.1–12.7). In contrast, incidence of cardiac events was lower for CVT that
VTE (1.7% vs. 3.6% at 5 years). Mortality risk was higher after CVT compared with
VTE, at 6 months (6.6% vs. 3.8%), but the risks differed little at 5 years (14.3%
vs. 14.1%).
Conclusion Intracranial bleeding, ischemic stroke, and mortality risks were higher for patients
with CVT than matched patients with VTE and the general population, particularly within
6 months after diagnosis.
Keywords
sinuses - cerebral venous thrombosis - stroke - hemorrhage - cardiovascular events
