Publication: Provoked versus unprovoked venous thromboembolism: Findings from GARFIELD-VTE
Issued Date
2021-02-01
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ISSN
24750379
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2-s2.0-85101065342
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Mahidol University
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SCOPUS
Bibliographic Citation
Research and Practice in Thrombosis and Haemostasis. Vol.5, No.2 (2021), 326-341
Suggested Citation
Walter Ageno, Alfredo Farjat, Sylvia Haas, Jeffrey I. Weitz, Samuel Z. Goldhaber, Alexander G.G. Turpie, Shinya Goto, Pantep Angchaisuksiri, Joern Dalsgaard Nielsen, Gloria Kayani, Sebastian Schellong, Henri Bounameaux, Lorenzo G. Mantovani, Paolo Prandoni, Ajay K. Kakkar Provoked versus unprovoked venous thromboembolism: Findings from GARFIELD-VTE. Research and Practice in Thrombosis and Haemostasis. Vol.5, No.2 (2021), 326-341. doi:10.1002/rth2.12482 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/78463
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Title
Provoked versus unprovoked venous thromboembolism: Findings from GARFIELD-VTE
Other Contributor(s)
Ramathibodi Hospital
Thrombosis & Atherosclerosis Research Institute
IRCCS Multimedica
McMaster University
Università degli Studi di Milano
Tokai University School of Medicine
University College London
Technical University of Munich
Brigham and Women's Hospital
Copenhagen University Hospital
Thrombosis Research Institute
Università degli Studi dell'Insubria
Municipal Hospital Dresden
Faculty of Medicine
Arianna Foundation on Anticoagulation
Thrombosis & Atherosclerosis Research Institute
IRCCS Multimedica
McMaster University
Università degli Studi di Milano
Tokai University School of Medicine
University College London
Technical University of Munich
Brigham and Women's Hospital
Copenhagen University Hospital
Thrombosis Research Institute
Università degli Studi dell'Insubria
Municipal Hospital Dresden
Faculty of Medicine
Arianna Foundation on Anticoagulation
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.