Abstract

Introduction

Venous thromboembolism (VTE) has a long‐term risk of recurrence, dependent on the presence or absence of provoking risk factors at the time of the event.

Objective

To compare clinical characteristics, anticoagulant patterns, and 12‐month outcomes in patients with transient provoking factors, active cancer, and unprovoked VTE.

Methods

The Global Anticoagulant Registry in the FIELD (GARFIELD)‐VTE is a prospective, observational study that enrolled 10 207 patients with objectively diagnosed VTE from 415 sites in 28 countries.

Results

Patients with transient provoking factors were younger (53.0 years) and more frequently women (61.2%) than patients with unprovoked VTE (60.3 years; 43.0% women) or active cancer (63.6 years; 51.7% women). After 6 months, 59.1% of patients with transient provoking factors remained on anticoagulation, compared to 71.3% with unprovoked VTE and 47.3% with active cancer. At 12 months, this decreased to 36.7%, 51.5%, and 25.4%, respectively. The risk of mortality (hazard ratio [HR], 1.21; 95% confidence interval [CI], 0.90‐1.62), recurrent VTE (HR, 0.84; 95% CI, 0.62‐1.14), and major bleeding (HR, 1.26; 95% CI, 0.86‐1.85) was comparable in patients with transient provoking factors and unprovoked VTE. Patients with minor and major transient provoking factors had a similar risk of recurrent VTE (HR, 0.99; 95% CI, 0.59‐1.66), but those with major transient risk factors had a lower risk of death (HR, 0.61; 95% CI, 0.38‐0.98).

Conclusion

At 1 year, nearly 40% of patients with transient provoking factors and slightly over half of patients with unprovoked VTE were on anticoagulant treatment. Event rates were comparable between the two groups. Risk of death was higher in patients with minor transient factors than in those with major transient factors.

Details

Title
Provoked versus unprovoked venous thromboembolism: Findings from GARFIELD‐VTE
Author
Ageno, Walter 1 ; Farjat, Alfredo 2 ; Haas, Sylvia 3 ; Weitz, Jeffrey I 4 ; Goldhaber, Samuel Z 5 ; Turpie, Alexander G G 6 ; Goto, Shinya 7 ; Angchaisuksiri, Pantep 8 ; Joern Dalsgaard Nielsen 9 ; Kayani, Gloria 2 ; Schellong, Sebastian 10 ; Bounameaux, Henri 11 ; Mantovani, Lorenzo G 12 ; Prandoni, Paolo 13 ; Kakkar, Ajay K 14 

 Department of Medicine and Surgery, University of Insubria, Varese, Italy 
 Thrombosis Research Institute, London, UK 
 Formerly Technical University of Munich, Munich, Germany 
 McMaster University and the Thrombosis and Atherosclerosis Research Institute, Hamilton, ON, Canada 
 Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA 
 McMaster University, Hamilton, ON, Canada 
 Department of Medicine (Cardiology), Tokai University School of Medicine, Shibuya City, Japan 
 Department of Medicine, Ramathibodi Hospital, Mahidol University, Nakhon Pathom, Thailand 
 Copenhagen University Hospital, Copenhagen, Denmark 
10  Medical Department 2, Municipal Hospital Dresden, Dresden, Germany 
11  Faculty of Medicine, Geneva, Switzerland 
12  IRCCS Multimedica, Milan, Italy; University of Milano, Milan, Italy 
13  Arianna Foundation on Anticoagulation, Bologna, Italy 
14  Thrombosis Research Institute, London, UK; University College London, London, UK 
Pages
326-341
Section
ORIGINAL ARTICLES ‐ THROMBOSIS
Publication year
2021
Publication date
Feb 2021
Publisher
Elsevier Limited
e-ISSN
24750379
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2497944566
Copyright
© 2021. This work is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.