Sylvia HaasWalter AgenoJeffrey I. WeitzSamuel Z. GoldhaberAlexander G.G. TurpieShinya GotoPantep AngchaisuksiriJoern Dalsgaard NielsenGloria KayaniAudrey ZaghdounAlfredo E. FarjatSebastian SchellongHenri BounameauxLorenzo G. MantovaniPaolo PrandoniAjay K. KakkarThrombosis & Atherosclerosis Research InstituteMcMaster UniversityTokai University School of MedicineUCLTechnical University of MunichFaculty of Medicine, Ramathibodi Hospital, Mahidol UniversityCopenhagen University HospitalThrombosis Research InstituteUniversity of Milano - BicoccaHôpitaux universitaires de GenèveUniversità degli Studi dell'InsubriaHarvard Medical SchoolArianna Foundation on AnticoagulationHospital Dresden2020-01-272020-01-272019-10-01Journal of Thrombosis and Haemostasis. Vol.17, No.10 (2019), 1694-170615387836153879332-s2.0-85069836660https://repository.li.mahidol.ac.th/handle/20.500.14594/51405© 2019 International Society on Thrombosis and Haemostasis Background: Parenteral anticoagulants and vitamin K antagonists (VKAs) have constituted the cornerstone of venous thromboembolism (VTE) treatment. Meanwhile, direct oral anticoagulants (DOACs) provide physicians with an alternative. The Global Anticoagulant Registry in the FIELD (GARFIELD)-VTE observes real-world treatment practices. Objectives: Describe initial anticoagulation (AC) treatment patterns in VTE patients who received parenteral AC, VKAs, and/or DOACs within ±30 days of diagnosis. Methods: VTE patients were categorized into parenteral AC only, parenteral AC with transition to VKA, VKA only, parenteral AC with transition to DOAC, and DOAC only. Results: A total of 9647 patients were initiated on AC treatment alone. 4781 (49.6%) patients received DOACs ± parenteral ACs; 3187 (33.0%), VKA ± parenteral ACs; and 1679 (17.4%) parenteral ACs alone. Rivaroxaban was the most frequently used DOAC (79.4%). DOACs were more frequently used in North America/Australia (58.1%), Europe (52.2%), and Asia (47.6%) than in Latin America (29.7%) and the Middle East/South Africa (32.5%). In patients with suspected VTE, most received parenteral AC monotherapy (67.7%). Patients with deep vein thrombosis were more likely to receive DOACs alone than those with pulmonary embolism with or without deep vein thrombosis (36.2% vs 25.9%). Active cancer patients received parenteral AC alone (58.9%), with 25.5% receiving DOAC ± parenteral AC and 12.8% parenteral AC and VKA. A total of 46.5% of pregnant patients received parenteral AC monotherapy, 34.0% were treated with VKA ± parenteral AC, and 19.5% received a DOAC (± parenteral AC). Conclusion: AC treatment patterns vary by patient population, geographic region and site of VTE. Guidelines for AC therapy are not always adhered to.Mahidol UniversityMedicineArticleSCOPUS10.1111/jth.14548