Publication: The influence of anemia on clinical outcomes in venous thromboembolism: Results from GARFIELD-VTE
Issued Date
2021-07-01
Resource Type
ISSN
18792472
00493848
00493848
Other identifier(s)
2-s2.0-85107683261
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Mahidol University
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SCOPUS
Bibliographic Citation
Thrombosis Research. Vol.203, (2021), 155-162
Suggested Citation
Shinya Goto, Alexander G.G. Turpie, Alfredo E. Farjat, Jeffrey I. Weitz, Sylvia Haas, Walter Ageno, Samuel Z. Goldhaber, Pantep Angchaisuksiri, Gloria Kayani, Peter MacCallum, Sebastian Schellong, Henri Bounameaux, Lorenzo G. Mantovani, Paolo Prandoni, Ajay K. Kakkar The influence of anemia on clinical outcomes in venous thromboembolism: Results from GARFIELD-VTE. Thrombosis Research. Vol.203, (2021), 155-162. doi:10.1016/j.thromres.2021.05.007 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/78092
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Title
The influence of anemia on clinical outcomes in venous thromboembolism: Results from GARFIELD-VTE
Other Contributor(s)
Ramathibodi Hospital
Thrombosis & Atherosclerosis Research Institute
IRCCS Multimedica
McMaster University
Tokai University School of Medicine
Université de Genève Faculté de Médecine
University College London
Technical University of Munich
Thrombosis Research Institute
Università degli Studi di Milano-Bicocca
Università degli Studi dell'Insubria
Harvard Medical School
Municipal Hospital Dresden
Arianna Foundation on Anticoagulation
Thrombosis & Atherosclerosis Research Institute
IRCCS Multimedica
McMaster University
Tokai University School of Medicine
Université de Genève Faculté de Médecine
University College London
Technical University of Munich
Thrombosis Research Institute
Università degli Studi di Milano-Bicocca
Università degli Studi dell'Insubria
Harvard Medical School
Municipal Hospital Dresden
Arianna Foundation on Anticoagulation
Abstract
Introduction: Clinical characteristics and outcomes of venous thromboembolism (VTE) patients with concomitant anemia are unclear. This study compares baseline characteristics, treatment patterns, and 24-month outcomes in patients with and without anemia within GARFIELD-VTE. Materials and methods: GARFIELD-VTE (ClinicalTrials.gov: NCT02155491) is a global, prospective, non-interventional registry of real-world treatment practices. Of the 10,679 patients enrolled in GARFIELD-VTE, 7698 were eligible for analysis. Primary outcomes were all-cause mortality, recurrent VTE, and major bleeding in VTE patients with or without concomitant anemia over 24-months after diagnosis. Event rates and 95% confidence intervals were estimated using Poisson regression. Adjusted hazard ratios were calculated using Cox proportional hazard models. Results: Distribution of VTE events in 2771 patients with anemia and 4927 without anemia was similar (deep-vein thrombosis alone: 61·1% vs. 55·9%, pulmonary embolism ± deep vein thrombosis: 38·9% vs. 44·0%, respectively). Patients with anemia were older (62.6 year vs. 58.9 years) than those without. At baseline, VTE risk factors that were more common in patients with anemia included hospitalization (22·0% vs. 6·8%), surgery (19·2% vs. 8·2%), cancer (20·1% vs. 5·6%) and acute medical illness (8·3% vs. 4·2%). Patients with anemia were more likely to receive parenteral anticoagulation therapy alone than those without anemia (26·6% vs. 11·7%) and less likely to receive a direct oral anticoagulant (38·5% vs. 53·5%). During 24-months of follow-up, patients with anemia had a higher risk (adjusted hazard ratio [95% confidence interval]) of all-cause mortality (1·84 [1·56–2·18]), major bleeding (2·83 [2·14–3·75]). Among anemia patients, the risk of all-cause mortality and major bleeding remained higher in patients with severe anemia than in those with mild/moderate anemia, all-cause mortality: HR 1·43 [95% CI: 1·21–1·77]; major bleeding: HR 2·08 [95% CI: 1·52–2·86]). Conclusions: VTE patients with concomitant anemia have a higher risk of adverse clinical outcomes compared with those without anemia. Further optimization of anticoagulation therapy for VTE patients with anemia is warranted.