Antipsychotic drugs and the risk of recurrent venous thromboembolism: A prospective cohort study

作者：Mollard L M; Le Mao R; Tromeur C; Le Moigne E; Gouillou M; Pan Petesch B; Delluc A; Couturaud F; Lacut K^*

来源：European Journal of Internal Medicine, 2018, 52: 22-27.

DOI：10.1016/j.ejim.2018.02.030

• Venous thromboembolism
• Pulmonary embolism
• Antipsychotic agents
• Recurrence
• Cohort study

Background: Numerous studies have suggested that antipsychotic drugs are associated with an increased risk for a first episode of venous thromboembolism (VTE). However, after anticoagulation discontinuation, the impact of antipsychotic drugs on the risk of recurrent VTE (rVTE) remains unknown.
Objective: To estimate the risk of rVTE in association with antipsychotic drugs.
Methods: Between May 2000 and December 2012, we included all consecutive patients with a first unprovoked symptomatic VTE and who discontinued anticoagulation. During follow-up, exposure to antipsychotic drugs was systematically assessed.
Results: A total of 736 patients with a first unprovoked symptomatic VTE were followed-up during a median period of 27.0 months (interquartile range (IQR) 6.2-60.0). Patients' median age was 66.0 years (IQR 49.0-76.0), 404 (54.9%) were men, and 61 (8.3%) were exposed to antipsychotics during follow-up. The incidence rate of r VTE was 12.1% person-year (95% CI 7.2-20.5) in antipsychotics users compared with 8.3% person-year (95% CI 7.1-9.8) in non-users (p = 0.20). Multivariate analysis showed a significant increased risk of recurrence associated with antipsychotic exposure (adjusted hazard ratio 1.9, 95% CI 1.1-3.3).
Conclusions: In this cohort study, exposure to antipsychotic drugs was found to be associated with an increased risk of rVTE among patients with a previous first unprovoked symptomatic VTE and who discontinued anticoagulation. Larger studies are needed to confirm and further explore this association.

• 出版日期2018-6