Inflammatory bowel disease is a risk factor for recurrent venous thromboembolism

Gastroenterology. 2010 Sep;139(3):779-87, 787.e1. doi: 10.1053/j.gastro.2010.05.026. Epub 2010 Jun 12.


Background & aims: Patients with inflammatory bowel disease (IBD) are at increased risk of a first venous thromboembolism (VTE), yet their risk of recurrent VTE is unknown. We performed a cohort study to determine the risk for recurrent VTE among patients with IBD compared with subjects without IBD.

Methods: We assessed 2811 patients with IBD for a history of VTE, recruited from outpatient clinics at 14 referral centers (June 2006-December 2008). Patients with VTE before a diagnosis of IBD or those not confirmed to have VTE, cancer, or a VTE other than deep vein thrombosis or pulmonary embolism, were excluded. Recurrence rates were compared with 1255 prospectively followed patients without IBD that had a first unprovoked VTE (not triggered by trauma, surgery, or pregnancy). The primary end point was symptomatic, objectively confirmed, recurrent VTE after discontinuation of anticoagulation therapy after a first VTE.

Results: Overall, of 116 IBD patients who had a history of first VTE, 86 were unprovoked. The probability of recurrence 5 years after discontinuation of anticoagulation therapy was higher among patients with IBD than patients without IBD (33.4%; 95% confidence interval [CI]: 21.8-45.0 vs 21.7%; 95% CI: 18.8-24.6; P = .01). After adjustment for potential confounders, IBD was an independent risk factor of recurrence (hazard ratio = 2.5; 95% CI: 1.4-4.2; P = .001).

Conclusions: Patients with IBD are at an increased risk of recurrent VTE compared to patients without IBD.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anticoagulants / administration & dosage
  • Austria
  • Case-Control Studies
  • Chi-Square Distribution
  • Drug Administration Schedule
  • Female
  • Gastrointestinal Agents / therapeutic use
  • Humans
  • Inflammatory Bowel Diseases / complications*
  • Inflammatory Bowel Diseases / drug therapy
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Prospective Studies
  • Pulmonary Embolism / diagnosis
  • Pulmonary Embolism / drug therapy
  • Pulmonary Embolism / etiology*
  • Recurrence
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Venous Thromboembolism / diagnosis
  • Venous Thromboembolism / drug therapy
  • Venous Thromboembolism / etiology*
  • Venous Thrombosis / diagnosis
  • Venous Thrombosis / drug therapy
  • Venous Thrombosis / etiology*


  • Anticoagulants
  • Gastrointestinal Agents