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Introduction: The incidence of cardiovascular events among cancer patients with bone metastases is poorly understood. We examined rates of cardiovascular events among cancer patients with bone metastases and mortality following such events., Methods: Using Danish health registries, we identified all Danish cancer patients diagnosed with bone metastases (1994-2013) and followed them from bone metastasis diagnosis. We computed incidence rates (IR) per 100 person-years and cumulative incidence for first-time inpatient hospitalization or outpatient clinic visit for cardiovascular events, defined as myocardial infarction, ischemic stroke, or venous thromboembolism (VTE). We also analyzed all-cause mortality rates including cardiovascular events as time-varying exposure with adjustment for age, sex, and Charlson Comorbidity Index score. All analyses were performed overall and stratified by cancer type (prostate, breast, lung, and other)., Results: We included 23,113 cancer patients with bone metastases. The cumulative incidence of cardiovascular events was 1.3% at 30 days, 3.7% at 1 year, and 5.2% at 5 years of follow-up. The highest IR was observed for VTE, followed by ischemic stroke and myocardial infarction, both overall and by cancer types. Lung cancer patients with bone metastases had the highest incidence of cardiovascular events followed by prostate and breast cancer. Occurrence of any cardiovascular event was a strong predictor of death (5 years following the event, the adjusted hazard ratio was 1.8 [95% confidence interval: 1.7-1.9])., Conclusion: Cancer patients with bone metastases had a substantial risk of developing cardiovascular events, and these events were associated with a subsequent increased mortality. Our findings underscore the importance of continuous optimized prevention of and care for cardiovascular disease among cancer patients with bone metastases., (© 2021 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)

Background: Myocardial infarction (MI) is a risk factor for venous thromboembolism (VTE). Although comorbidities affect MI prognosis, it is unclear whether they affect VTE risk after MI., Objectives: We examined the impact of comorbidity on VTE risk after MI., Methods: We used nationwide population-based registries to identify first-time hospitalizations for MI and subsequent occurrence of VTE in Denmark (1995-2013). We included a comparison cohort from the general population matched 5:1 with MI patients by sex, age, and comorbidities. We computed 30-day and 1- to 12-month cumulative risks, rates, and hazard ratios of VTE. We also assessed the interaction between MI and comorbidity, defined as excess VTE risk in patients with both MI and comorbidity, by computing interaction contrasts and attributable fractions relating to the interaction., Results: Thirty-day and 1- to 12-month VTE risks were 0.6% and 0.5% in the MI cohort (n = 160 338) and 0.03% and 0.3% in the comparison cohort (n = 792 384). The 30-day hazard ratio for VTE in the MI cohort was 23 (95% confidence interval, 20-27), which decreased during 1-year follow-up. Thirty days after MI, interactions between MI and comorbidity accounted for 16% and 39% of VTE rates in MI patients with low-to-moderate and high comorbidity, respectively. The interactions were driven primarily by hemiplegia and cancer., Conclusions: Thirty-day VTE risk was substantially increased after MI compared with the general population. Although the absolute VTE risk was low, comorbidity substantially increased this risk, especially hemiplegia and cancer. VTE prophylaxis might be indicated in such high-risk patients but warrants further investigation., (© 2020 International Society on Thrombosis and Haemostasis.)

Background Childhood weight trajectories may influence cardiometabolic traits and thereby the risk of venous thromboembolism ( VTE ) later in life. We examined whether overweight and changes in weight status during childhood were associated with risk of VTE in adulthood. Methods and Results We used Danish medical registries to conduct a population-based cohort study of Danish schoolchildren aged 7 to 13 years and born during 1930-1989. We calculated body-mass index ( BMI ) z-scores based on weight and height measurements. We estimated hazard ratios using Cox regressions to examine associations between changes in BMI z-scores from 7 to 13 years of age and the subsequent risk of VTE . Among 313 998 children, 5007 girls and 5397 boys were diagnosed with VTE as adults. Compared with children with a normal BMI (25th to 75th percentile category) at both ages, children with a BMI persistently above the 75th percentile had a 1.30- to 1.50-fold increased risk of VTE in adulthood. Children who experienced a BMI increase from the 25th to 75th or >75th to 90th percentile to a higher percentile category had a 1.35- to 1.70-fold increased risk of adulthood VTE . Children whose BMI percentile category decreased between 7 and 13 years of age had a VTE risk similar to that of children with a persistently normal BMI . Conclusions Risk of VTE in adulthood was higher in children with a persistently above-average BMI . Whereas weight gain from 7 to 13 years of age additionally increased VTE risk, remission from overweight by 13 years of age completely reverted the risk.

Background: Patients with atrial fibrillation or flutter (AFF) are at increased risk of ischemic stroke, but their risk of other thromboembolic events remains less clear., Methods: During 2004-2013, we conducted a nationwide population-based cohort study using Danish medical registries. We identified all patients with first-time AFF and sampled a sex-, age-, and calendar year-matched general population comparison cohort without AFF. For myocardial infarction, peripheral embolism, ischemic stroke, hemorrhagic stroke, deep venous thrombosis, and pulmonary embolism, we computed cumulative risks and adjusted incidence rate ratios (aIRRs) adjusted for comorbidity and medication., Results: The study population consisted of 103,989 patients with AFF and 519,935 individuals without AFF from the general population. Ten-year cumulative risks in the AFF cohort were 3.5% for myocardial infarction, 0.5% for peripheral embolism, 6.7% for ischemic stroke, 1.3% for hemorrhagic stroke, 1.0% for deep venous thrombosis, and 1.3% for pulmonary embolism. During the first 30days following AFF, aIRRs were markedly (4 to 16-fold) increased for all outcomes and similarly elevated for myocardial infarction (aIRR=8.0, 95% confidence interval (CI): 6.8-9.5) and ischemic stroke (aIRR=9.9, 95% CI: 8.5-11.5). Thereafter, aIRRs decreased gradually, reaching unity after 5years for myocardial infarction, deep venous thrombosis, and pulmonary embolism, but remained 1.6 to 3.5-fold increased for peripheral embolism, ischemic stroke, and hemorrhagic stroke., Conclusions: AFF was a risk factor for all arterial and venous outcomes during the first year of follow-up, but only for peripheral embolism, ischemic stroke, and hemorrhagic stroke thereafter., (Copyright © 2017 Elsevier B.V. All rights reserved.)