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

Walter Ageno; Sylvia Haas; Jeffrey I. Weitz; Samuel Z. Goldhaber; Alexander G. G. Turpie; Shinya Goto; Pantep Angchaisuksiri; Joern Dalsgaard Nielsen; Gloria Kayani; Karen S. Pieper; Sebastian Schellong; Henri Bounameaux; Lorenzo G. Mantovani; Paolo Prandoni; Ajay K. Kakkar; on behalf of the GARFIELD-VTE investigators

doi:10.1055/s-0038-1676611

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2019; 119(02): 319-327
DOI: 10.1055/s-0038-1676611

Stroke, Systemic or Venous Thromboembolism

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

Walter Ageno

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

,

Sylvia Haas

²Technical University of Munich, Munich, Germany

,

Jeffrey I. Weitz

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

,

Samuel Z. Goldhaber

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

,

Alexander G. G. Turpie

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

,

Shinya Goto

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

,

Pantep Angchaisuksiri

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

,

Joern Dalsgaard Nielsen

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

,

Gloria Kayani

⁹Thrombosis Research Institute, London, United Kingdom

,

Karen S. Pieper

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

,

Sebastian Schellong

¹¹Medical Department 2, Municipal Hospital, Dresden, Germany

,

Henri Bounameaux

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

,

Lorenzo G. Mantovani

¹³University Degli Studi di Milano, Bicocca, Italy

,

Paolo Prandoni

¹⁴Arianna Foundation on Anticoagulation, Bologna, Italy

,

Ajay K. Kakkar

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

,

on behalf of the GARFIELD-VTE investigators

› Author Affiliations

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.

Keywords

venous thromboembolism - registry - deep vein thrombosis - pulmonary embolism - anticoagulation

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