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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
1   Department of Medicine and Surgery, University of Insubria, Varese, Italy
,
Sylvia Haas
2   Technical University of Munich, Munich, Germany
,
Jeffrey I. Weitz
3   Thrombosis and Atherosclerosis Research Institute, McMaster University, Hamilton, Ontario, Canada
,
Samuel Z. Goldhaber
4   Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States
,
Alexander G. G. Turpie
5   Department of Medicine, McMaster University, Hamilton, Ontario, Canada
,
Shinya Goto
6   Department of Medicine (Cardiology), Tokai University School of Medicine, Tokai University, Tokai, Japan
,
Pantep Angchaisuksiri
7   Department of Medicine, Ramathibodi Hospital, Mahidol University, Mahidol, Thailand
,
Joern Dalsgaard Nielsen
8   Department of Cardiology, Copenhagen University Hospital, Copenhagen University, Copenhagen, Denmark
,
Gloria Kayani
9   Thrombosis Research Institute, London, United Kingdom
,
Karen S. Pieper
10   Department of Statistical Research Science, Duke Clinical Research Institute, Durham, North Carolina, United States
,
Sebastian Schellong
11   Medical Department 2, Municipal Hospital, Dresden, Germany
,
Henri Bounameaux
12   Faculty of Medicine, University Hospital of Geneva, University of Geneva, Geneva, Switzerland
,
Lorenzo G. Mantovani
13   University Degli Studi di Milano, Bicocca, Italy
,
Paolo Prandoni
14   Arianna Foundation on Anticoagulation, Bologna, Italy
,
Ajay K. Kakkar
15   Thrombosis Research Institute, University College London, London, United Kingdom
,
on behalf of the GARFIELD-VTE investigators › Institutsangaben Funding The GARFIELD-VTE registry is an independent academic research initiative sponsored by the Thrombosis Research Institute (London, United Kingdom) and supported by an unrestricted research grant from Bayer Pharma AG (Berlin, Germany).
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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

Note

The lead authors affirm that the manuscript is an honest, accurate and transparent account of the study being reported; that no important aspects of the study have been omitted.


Ethical Approval

Independent ethics committee and hospital-based institutional review board approvals were obtained, as necessary, for the registry protocol.


* A full list of investigators is given in Supplementary Appendix A available in the online version.


Supplementary Material



Publikationsverlauf

Eingereicht: 10. September 2018

Angenommen: 02. November 2018

Artikel online veröffentlicht:
28. Dezember 2018

Georg Thieme Verlag KG
Stuttgart · New York

 

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