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Provoked versus unprovoked venous thromboembolism: Findings from GARFIELD‐VTE

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 f...

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Autores principales: Ageno, Walter, Farjat, Alfredo, Haas, Sylvia, Weitz, Jeffrey I., Goldhaber, Samuel Z., Turpie, Alexander G. G., Goto, Shinya, Angchaisuksiri, Pantep, Dalsgaard Nielsen, Joern, Kayani, Gloria, Schellong, Sebastian, Bounameaux, Henri, Mantovani, Lorenzo G., Prandoni, Paolo, Kakkar, Ajay K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7938631/
https://www.ncbi.nlm.nih.gov/pubmed/33733032
http://dx.doi.org/10.1002/rth2.12482
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author Ageno, Walter
Farjat, Alfredo
Haas, Sylvia
Weitz, Jeffrey I.
Goldhaber, Samuel Z.
Turpie, Alexander G. G.
Goto, Shinya
Angchaisuksiri, Pantep
Dalsgaard Nielsen, Joern
Kayani, Gloria
Schellong, Sebastian
Bounameaux, Henri
Mantovani, Lorenzo G.
Prandoni, Paolo
Kakkar, Ajay K.
author_facet Ageno, Walter
Farjat, Alfredo
Haas, Sylvia
Weitz, Jeffrey I.
Goldhaber, Samuel Z.
Turpie, Alexander G. G.
Goto, Shinya
Angchaisuksiri, Pantep
Dalsgaard Nielsen, Joern
Kayani, Gloria
Schellong, Sebastian
Bounameaux, Henri
Mantovani, Lorenzo G.
Prandoni, Paolo
Kakkar, Ajay K.
author_sort Ageno, Walter
collection PubMed
description 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.
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spelling pubmed-79386312021-03-16 Provoked versus unprovoked venous thromboembolism: Findings from GARFIELD‐VTE Ageno, Walter Farjat, Alfredo Haas, Sylvia Weitz, Jeffrey I. Goldhaber, Samuel Z. Turpie, Alexander G. G. Goto, Shinya Angchaisuksiri, Pantep Dalsgaard Nielsen, Joern Kayani, Gloria Schellong, Sebastian Bounameaux, Henri Mantovani, Lorenzo G. Prandoni, Paolo Kakkar, Ajay K. Res Pract Thromb Haemost Original Articles ‐ Thrombosis 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. John Wiley and Sons Inc. 2021-02-20 /pmc/articles/PMC7938631/ /pubmed/33733032 http://dx.doi.org/10.1002/rth2.12482 Text en © 2021 The Authors. Research and Practice in Thrombosis and Haemostasis published by Wiley Periodicals LLC on behalf of International Society on Thrombosis and Haemostasis (ISTH). This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles ‐ Thrombosis
Ageno, Walter
Farjat, Alfredo
Haas, Sylvia
Weitz, Jeffrey I.
Goldhaber, Samuel Z.
Turpie, Alexander G. G.
Goto, Shinya
Angchaisuksiri, Pantep
Dalsgaard Nielsen, Joern
Kayani, Gloria
Schellong, Sebastian
Bounameaux, Henri
Mantovani, Lorenzo G.
Prandoni, Paolo
Kakkar, Ajay K.
Provoked versus unprovoked venous thromboembolism: Findings from GARFIELD‐VTE
title Provoked versus unprovoked venous thromboembolism: Findings from GARFIELD‐VTE
title_full Provoked versus unprovoked venous thromboembolism: Findings from GARFIELD‐VTE
title_fullStr Provoked versus unprovoked venous thromboembolism: Findings from GARFIELD‐VTE
title_full_unstemmed Provoked versus unprovoked venous thromboembolism: Findings from GARFIELD‐VTE
title_short Provoked versus unprovoked venous thromboembolism: Findings from GARFIELD‐VTE
title_sort provoked versus unprovoked venous thromboembolism: findings from garfield‐vte
topic Original Articles ‐ Thrombosis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7938631/
https://www.ncbi.nlm.nih.gov/pubmed/33733032
http://dx.doi.org/10.1002/rth2.12482
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