Isolated Distal Deep Vein Thrombosis: Perspectives from the GARFIELD-VTE Registry

Sebastian M. Schellong; Samuel Z. Goldhaber; Jeffrey I. Weitz; Walter Ageno; Henri Bounameaux; Alexander G. G. Turpie; Pantep Angchaisuksiri; Sylvia Haas; Shinya Goto; Audrey Zaghdoun; Alfredo Farjat; Joern Dalsgaard Nielsen; Gloria Kayani; Lorenzo G. Mantovani; Paolo Prandoni; Ajay K. Kakkar

doi:10.1055/s-0039-1693461

Thrombosis and Haemostasis, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · Thromb Haemost 2019; 119(10): 1675-1685
DOI: 10.1055/s-0039-1693461

Stroke, Systemic or Venous Thromboembolism

Georg Thieme Verlag KG Stuttgart · New York

Isolated Distal Deep Vein Thrombosis: Perspectives from the GARFIELD-VTE Registry

Sebastian M. Schellong

¹Medical Division 2, Municipal Hospital Dresden-Friedrichstadt, Dresden, Germany

,

Samuel Z. Goldhaber

²Harvard Medical School, Harvard University, Boston, Massachusetts, United States

,

Jeffrey I. Weitz

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

,

Walter Ageno

⁴Department of Medicine and Surgery, University of Insubria, Varese, Italy

,

Henri Bounameaux

⁵Faculty of Medicine, University Hospitals of Geneva, Geneva, Switzerland

,

Alexander G. G. Turpie

⁶McMaster University, Hamilton, Ontario, Canada

,

Pantep Angchaisuksiri

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

,

Sylvia Haas

⁸Department of Medicine, Technical University of Munich, Munich, Germany

,

Shinya Goto

⁹Department of Medicine (Cardiology), Tokai University School of Medicine, Tokyo, Japan

,

Audrey Zaghdoun

¹⁰Thrombosis Research Institute, London, United Kingdom

,

Alfredo Farjat

¹⁰Thrombosis Research Institute, London, United Kingdom

,

Joern Dalsgaard Nielsen

¹¹Copenhagen University Hospital, Copenhagen, Denmark

,

Gloria Kayani

¹⁰Thrombosis Research Institute, London, United Kingdom

,

Lorenzo G. Mantovani

¹²University Degli Studi di Milano Bicocca, Milan, Italy

,

Paolo Prandoni

¹³Arianna Foundation on Anticoagulation, Bologna, Italy

,

Ajay K. Kakkar

¹⁴Thrombosis Research Institute, University College London, London, United Kingdom

› Institutsangaben

Abstract

Isolated distal deep vein thrombosis (IDDVT) represents up to half of all lower limb DVT. This study investigated treatment patterns and outcomes in 2,145 patients with IDDVT in comparison with those with proximal DVT (PDVT; n = 3,846) and pulmonary embolism (PE; n = 4,097) enrolled in the GARFIELD-VTE registry. IDDVT patients were more likely to have recently undergone surgery (14.6%) or experienced leg trauma (13.2%) than PDVT patients (11.0 and 8.7%, respectively) and PE patients (12.7 and 4.5%, respectively). Compared with IDDVT, patients with PDVT or PE were more likely to have active cancer (7.2% vs. 9.9% and 10.3%). However, influence of provoking factors on risk of recurrence in IDDVT remains controversial. Nearly all patients (IDDVT, PDVT, and PE) were given anticoagulant therapy. In IDDVT, PDVT, and PE groups the proportion of patients receiving anticoagulant therapy was 61.4, 73.9, and 81.1% at 6 months and 45.8, 54.7, and 61.9% at 12 months. Over 12 months, the incidence of all-cause mortality, cancer, and recurrence was significantly lower in IDDVT patients than PDVT patients (hazard ratio [HR], 0.61 [95% confidence interval [CI], 0.48–0.77]; sub-HR [sHR], 0.60 [95% CI, 0.39–0.93]; and sHR, 0.76 [95% CI, 0.60–0.97]). Likewise, risk of death and incident cancer was significantly (both p < 0.05) lower in patients with IDDVT compared with PE. This study reveals a global trend that most IDDVT patients as well as those with PDVT and PE are given anticoagulant therapy, in many cases for at least 12 months.

Keywords

deep vein thrombosis - isolated distal deep vein thrombosis - 12-month observational study - GARFIELD-VTE registry

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Referenzen

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