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Alcohol use disorders are associated with venous thromboembolism

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Abstract

Moderate alcohol consumption has been suggested to protect against venous thromboembolism (VTE). However, it is not known how alcohol abuse and its associated somatic complications affect the risk of VTE. The present study determined the risk of pulmonary embolism (PE) and deep vein thrombosis (DVT) of the lower extremities in patients with alcohol use disorders (AUDs) in Sweden. All inpatients with AUDs in 2002–2010 without a previous VTE event (72,024 patients) were matched to five controls without AUD and followed until the end of follow-up (December 31, 2010), death, emigration or a VTE event. Cox regression was used to determine adjusted hazard ratios (HRs) for VTE. AUD patients were further divided into those without alcohol-related somatic complications (AUD−) and those with alcohol-related somatic complications (AUD+, i.e., encephalopathy, epilepsy, polyneuropathy, myopathy, cardiomyopathy, gastritis, liver disease, acute pancreatitis, and chronic pancreatitis). The adjusted HR for VTE was significantly increased for both AUD− (HR 1.70, 95 % CI 1.55–1.87) and AUD+ (HR 1.73, 95 % CI 1.37–2.19) patients. The risk of DVT was increased in both AUD+ and AUD− patients (HR 1.62, 95 % CI 1.45–1.83 and HR 1.99, 95 % CI 1.53–2.59, respectively). However, the risk of PE was only significantly increased in AUD− patients (HR 1.87, 95 % 1.59–1.20) and not in AUD+ patients (HR 1.16, 95 % 0.70–1.91). In conclusion, the present study shows that AUD increases the risk of VTE, even in the absence of alcohol-related somatic complications. Our findings suggest that severe alcohol abuse increases the risk of VTE.

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Acknowledgments

We thank Stephen Gilliver for his useful comments about the text. The registers used in the present study are maintained by Statistics Sweden and the National Board of Health and Welfare. This work was supported by grants awarded to Dr. Bengt Zöller by the Swedish Heart–Lung Foundation, the Swedish Research Council; to Dr. Kristina Sundquist by the Swedish Research Council and The Swedish Research Council for Health, Working Life and Welfare (In Swedish: Forte; Reg.nr: 2013-1836); and to Dr. Jan Sundquist by the Swedish Research Council and the Swedish Freemasons Foundation, as well as by ALF funding from Region Skåne awarded to Drs. Zöller, Kristina Sundquist, and Jan Sundquist.

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None declared.

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Authors and Affiliations

  1. Center for Primary Health Care Research, Skåne University Hospital, Lund University/Region Skåne, CRC, Building 28, Floor 11, Jan Waldenströms gata 35, 205 02, Malmö, Sweden

    Bengt Zöller, Jianguang Ji, Jan Sundquist & Kristina Sundquist

  2. Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA

    Jan Sundquist & Kristina Sundquist

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  1. Bengt Zöller
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  2. Jianguang Ji
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  3. Jan Sundquist
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Correspondence to Bengt Zöller.

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Zöller, B., Ji, J., Sundquist, J. et al. Alcohol use disorders are associated with venous thromboembolism. J Thromb Thrombolysis 40, 167–173 (2015). https://doi.org/10.1007/s11239-015-1168-8

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