Congestive heart failure and outpatient risk of venous thromboembolism: A retrospective, case-control study

M. D. Howell, J. M. Geraci, Anne A Knowlton

Research output: Contribution to journalArticle

103 Scopus citations


Although CHF has been considered a risk factor for venous thromboembolism, this has not been directly studied. We hypothesized that congestive heart failure would increase the risk of venous thromboembolism in an outpatient population, and that this risk would increase as patients' ventricular function worsened. We conducted a case-control study to examine whether CHF due to left ventricular dysfunction was an independent risk factor for acute venous thromboembolism in outpatients, once established risk factors such as recent surgery and prior venous thromboembolism are taken into account. We reviewed 106 cases of DVT and 603 controls, admitted for diabetes mellitus or infection, matched for month of admission at a VA hospital. Assignment of a diagnosis of venous thromboembolism required a definitive test, as did classification as CHF. In a logistic regression model CHF was an independent predictor of venous thromboembolism. A second logistic regression model showed that the risk of venous thromboembolism increased as the ejection fraction (EF) decreased, with an EF < 20 associated with a venous thromboembolism OR of 38.3 (95% CI 9.6, 152.5). CHF is an independent risk factor for venous thromboembolism, and the risk increases markedly as the EF decreases. These results support the use of anticoagulation in selected patients with CHF.

Original languageEnglish (US)
Pages (from-to)810-816
Number of pages7
JournalJournal of Clinical Epidemiology
Issue number8
StatePublished - 2001
Externally publishedYes



  • Cardiomyopathy
  • Congestive heart failure
  • DVT
  • Pulmonary embolism
  • Thromboembolism

ASJC Scopus subject areas

  • Medicine(all)
  • Public Health, Environmental and Occupational Health
  • Epidemiology

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