Physical activity and risk of recurrence and mortality after incident venous thromboembolism

Abstract

Background: Limited data exist on the relationship between physical activity and major complications after incident venous thromboembolism (VTE).

Objectives: To investigate whether physical activity was associated with risk of recurrence and mortality in patients with VTE recruited from the general population.

Methods: Patients with incident VTE (n = 786) derived from the Tromsø Study surveys 4-6 (1994-1995, 2001-2002, and 2007-2008) were included, and data on physical activity were dichotomized according to the activity level reported in the survey preceding the incident VTE (inactive: <1 hour per week, active: ≥1 hour per week). Recurrent VTE and all-cause mortality were registered up to December 31, 2015. Hazard ratios (HRs) for recurrence and all-cause mortality were calculated using Cox regression models with the inactive group as reference.

Results: There were 139 recurrences and 395 deaths during follow-up. Physical activity was not associated with the risk of recurrence in men (HR model 2: 1.48, 95% confidence interval [CI] 0.83-2.65) or in women (HR model 2: 0.95, 95% CI 0.52-1.74). In contrast, physical activity was associated with a 28% lower risk of mortality during 10 years of follow up (HR model 3: 0.72, 95% CI 0.57-0.91). The inverse association was stronger in patients with a first deep vein thrombosis ( HR model 2: 0.59, 95% CI 0.44-0.79) than a pulmonary embolism (HR model 3: 0.87, 95% CI 0.61-1.26).

Conclusion: Our results suggest that habitual physical activity prior to incident VTE does not influence the risk of recurrence. In contrast, active individuals were at lower risk of mortality, particularly following deep vein thrombosis.

Keywords: epidemiology; physical activity; recurrence; risk factors; venous thromboembolism.