ArticleJournal of thrombosis and thrombolysis2026
Anaemia and long-term outcomes after surgical treatment of uterine fibroids: evidence from real-world data.
Article in Journal of thrombosis and thrombolysis, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Uterine leiomyomas are the most common benign gynaecological tumours and a major cause of heavy menstrual bleeding, frequently resulting in iron deficiency anaemia. However, the long-term cardiovascular and thromboembolic consequences of fibroid-related anaemia remain poorly understood. We conducted a retrospective cohort study using the TriNetX health research network (~ 160 million patients). Women with uterine fibroids undergoing surgical management were identified and stratified by the presence or absence of anaemia within three years before surgery. Propensity score matching (1:1) was applied to balance demographics and comorbidities. Twelve-month outcomes included all-cause mortality, myocardial infarction, stroke, atrial fibrillation/flutter, heart failure, and venous thromboembolism. Risk ratios (RR) with 95% confidence intervals (CI) were calculated. From 83,319 eligible patients, 9,581 anaemic and 9,581 non-anaemic women were well matched. At one year, the presence of anaemia was associated with higher risks of mortality (RR 1.93, 95% CI 1.04-3.60, p = 0.03), stroke (RR 1.65, 1.05-2.60, p = 0.02), atrial fibrillation/flutter (RR 1.60, 1.03-2.48, p = 0.03), heart failure (RR 1.97, 1.43-2.70, p < 0.0001), and venous thromboembolism (RR 2.15, 1.67-2.80, p < 0.0001). No significant difference was observed for myocardial infarction (RR 1.44, 0.80-2.60, p = 0.22). The composite cardiovascular outcome was significantly elevated (HR 1.74, 95% CI 1.44-2.09, p < 0.0001). Preoperative anaemia in women undergoing fibroid surgery independently predicts adverse cardiovascular and thromboembolic events and nearly doubled 12-month mortality. Early recognition and optimisation of anaemia may improve clinical outcomes.
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