Characteristics and Management of Patients with Venous Thromboembolism: The GARFIELD-VTE Registry

Author:

Ageno Walter1,Haas Sylvia2,Weitz Jeffrey3,Goldhaber Samuel4,Turpie Alexander5,Goto Shinya6,Angchaisuksiri Pantep7,Nielsen Joern8,Kayani Gloria9,Pieper Karen10,Schellong Sebastian11,Bounameaux Henri12,Mantovani Lorenzo13,Prandoni Paolo14,Kakkar Ajay15,

Affiliation:

1. Department of Medicine and Surgery, University of Insubria, Varese, Italy

2. Technical University of Munich, Munich, Germany

3. Thrombosis and Atherosclerosis Research Institute, McMaster University, Hamilton, Ontario, Canada

4. Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States

5. Department of Medicine, McMaster University, Hamilton, Ontario, Canada

6. Department of Medicine (Cardiology), Tokai University School of Medicine, Tokai University, Tokai, Japan

7. Department of Medicine, Ramathibodi Hospital, Mahidol University, Mahidol, Thailand

8. Department of Cardiology, Copenhagen University Hospital, Copenhagen University, Copenhagen, Denmark

9. Thrombosis Research Institute, London, United Kingdom

10. Department of Statistical Research Science, Duke Clinical Research Institute, Durham, North Carolina, United States

11. Medical Department 2, Municipal Hospital, Dresden, Germany

12. Faculty of Medicine, University Hospital of Geneva, University of Geneva, Geneva, Switzerland

13. University Degli Studi di Milano, Bicocca, Italy

14. Arianna Foundation on Anticoagulation, Bologna, Italy

15. Thrombosis Research Institute, University College London, London, United Kingdom

Abstract

Background Management of venous thromboembolism (VTE), encompassing both deep vein thrombosis (DVT) and pulmonary embolism (PE), varies worldwide. Methods The Global Anticoagulant Registry in the FIELD – Venous Thromboembolism (GARFIELD-VTE) is a prospective, observational study of 10,685 patients with objectively diagnosed VTE recruited from May 2014 to January 2017 at 417 sites in 28 countries. All patients are followed for at least 3 years. We describe the baseline characteristics of the study population and their management within 30 days of diagnosis. Results The median age was 60.2 years; 50.4% were male; 61.7% had DVT and 38.3% had PE ± DVT; and 32.3% were obese (body mass index ≥ 30 kg/m2). The most common risk factors were surgery (12.5%), hospitalization (12.0%) and trauma to the lower limbs (7.8%). At the time of VTE diagnosis, 10.1% had active cancer and 5.7% were chronically immobilized. Treatment for VTE was anticoagulant (AC) therapy alone in 90.9% of patients; 5.1% received thrombolytic and/or surgical/mechanical therapy ± AC and 4.0% received no therapy. Pre-diagnosis, 12.8% received AC therapy alone and 0.2% received thrombolytic and/or surgical/mechanical therapy ± AC. After diagnosis, parenteral AC therapy alone was administered in 17.6% of patients, and it was followed by a direct oral AC (DOAC) in 16.4% or a vitamin K antagonist (VKA) in 26.8%. DOACs alone were prescribed to 32.3% of patients, while 5.9% received VKA alone. Conclusion The initial findings from this global registry highlight the heterogeneity in characteristics and management of VTE patients. Prospective follow-up will reveal the impact of this heterogeneity on outcomes.

Publisher

Georg Thieme Verlag KG

Subject

Hematology

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