36-month clinical outcomes of patients with venous thromboembolism: Garfield-vte

Alexander G G Turpie; Alfredo E Farjat; Sylvia Haas; Walter Ageno; Jeffrey I Weitz; Samuel Z Goldhaber; Shinya Goto; Pantep Angchaisuksiri; Gloria Kayani; Renato D Lopes; Chern-En Chiang; Harry Gibbs; Eric Tse; Peter Verhamme; Hugo Ten Cate; Juan Muntaner; Sebastian Schellong; Henri Bounameaux; Paolo Prandoni; Uma Maheshwari; Ajay K Kakkar; GARFIELD-VTE Investigators

doi:10.1016/j.thromres.2022.11.016

36-month clinical outcomes of patients with venous thromboembolism: Garfield-vte

Alexander G G Turpie^*, Alfredo E Farjat, Sylvia Haas, Walter Ageno, Jeffrey I Weitz, Samuel Z Goldhaber, Shinya Goto, Pantep Angchaisuksiri, Gloria Kayani, Renato D Lopes, Chern-En Chiang, Harry Gibbs, Eric Tse, Peter Verhamme, Hugo Ten Cate, Juan Muntaner, Sebastian Schellong, Henri Bounameaux, Paolo Prandoni, Uma MaheshwariAjay K Kakkar, GARFIELD-VTE Investigators

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: Venous thromboembolism (VTE), encompassing both deep vein thrombosis (DVT) and pulmonary embolism (PE), is a leading cause of morbidity and mortality worldwide.

METHODS: GARFIELD-VTE is a prospective, non-interventional observational study of real-world treatment practices. We aimed to capture the 36-month clinical outcomes of 10,679 patients with objectively confirmed VTE enrolled between May 2014 and January 2017 from 415 sites in 28 countries.

FINDINGS: A total of 6582 (61.6 %) patients had DVT alone, 4097 (38.4 %) had PE ± DVT. At baseline, 98.1 % of patients received anticoagulation (AC) with or without other modalities of therapy. The proportion of patients on AC therapy decreased over time: 87.6 % at 3 months, 73.0 % at 6 months, 54.2 % at 12 months and 42.0 % at 36 months. At 12-months follow-up, the incidences (95 % confidence interval [CI]) of all-cause mortality, recurrent VTE and major bleeding were 6.5 (7.0-8.1), 5.4 (4.9-5.9) and 2.7 (2.4-3.0) per 100 person-years, respectively. At 36-months, these decreased to 4.4 (4.2-4.7), 3.5 (3.2-2.7) and 1.4 (1.3-1.6) per 100 person-years, respectively. Over 36-months, the rate of all-cause mortality and major bleeds were highest in patients treated with parenteral therapy (PAR) versus oral anti-coagulants (OAC) and no OAC, and the rate of recurrent VTE was highest in patients on no OAC versus those on PAR and OAC. The most frequent cause of death after 36-month follow-up was cancer (n = 565, 48.6 %), followed by cardiac (n = 94, 8.1 %), and VTE (n = 38, 3.2 %). Most recurrent VTE events were DVT alone (n = 564, 63.3 %), with the remainder PE, (n = 236, 27.3 %), or PE in combination with DVT (n = 63, 7.3 %).

INTERPRETATION: GARFIELD-VTE provides a global perspective of anticoagulation patterns and highlights the accumulation of events within the first 12 months after diagnosis. These findings may help identify treatment gaps for subsequent interventions to improve patient outcomes in this patient population.

Original language	English
Pages (from-to)	31-39
Number of pages	9
Journal	Thrombosis Research
Volume	222
Issue number	1
Early online date	25 Nov 2022
DOIs	https://doi.org/10.1016/j.thromres.2022.11.016
Publication status	Published - 1 Feb 2023

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Turpie, A. G. G., Farjat, A. E., Haas, S., Ageno, W., Weitz, J. I., Goldhaber, S. Z., Goto, S., Angchaisuksiri, P., Kayani, G., Lopes, R. D., Chiang, C.-E., Gibbs, H., Tse, E., Verhamme, P., Ten Cate, H., Muntaner, J., Schellong, S., Bounameaux, H., Prandoni, P., ... GARFIELD-VTE Investigators (2023). 36-month clinical outcomes of patients with venous thromboembolism: Garfield-vte. Thrombosis Research, 222(1), 31-39. https://doi.org/10.1016/j.thromres.2022.11.016

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title = "36-month clinical outcomes of patients with venous thromboembolism: Garfield-vte",

abstract = "BACKGROUND: Venous thromboembolism (VTE), encompassing both deep vein thrombosis (DVT) and pulmonary embolism (PE), is a leading cause of morbidity and mortality worldwide.METHODS: GARFIELD-VTE is a prospective, non-interventional observational study of real-world treatment practices. We aimed to capture the 36-month clinical outcomes of 10,679 patients with objectively confirmed VTE enrolled between May 2014 and January 2017 from 415 sites in 28 countries.FINDINGS: A total of 6582 (61.6 %) patients had DVT alone, 4097 (38.4 %) had PE ± DVT. At baseline, 98.1 % of patients received anticoagulation (AC) with or without other modalities of therapy. The proportion of patients on AC therapy decreased over time: 87.6 % at 3 months, 73.0 % at 6 months, 54.2 % at 12 months and 42.0 % at 36 months. At 12-months follow-up, the incidences (95 % confidence interval [CI]) of all-cause mortality, recurrent VTE and major bleeding were 6.5 (7.0-8.1), 5.4 (4.9-5.9) and 2.7 (2.4-3.0) per 100 person-years, respectively. At 36-months, these decreased to 4.4 (4.2-4.7), 3.5 (3.2-2.7) and 1.4 (1.3-1.6) per 100 person-years, respectively. Over 36-months, the rate of all-cause mortality and major bleeds were highest in patients treated with parenteral therapy (PAR) versus oral anti-coagulants (OAC) and no OAC, and the rate of recurrent VTE was highest in patients on no OAC versus those on PAR and OAC. The most frequent cause of death after 36-month follow-up was cancer (n = 565, 48.6 %), followed by cardiac (n = 94, 8.1 %), and VTE (n = 38, 3.2 %). Most recurrent VTE events were DVT alone (n = 564, 63.3 %), with the remainder PE, (n = 236, 27.3 %), or PE in combination with DVT (n = 63, 7.3 %).INTERPRETATION: GARFIELD-VTE provides a global perspective of anticoagulation patterns and highlights the accumulation of events within the first 12 months after diagnosis. These findings may help identify treatment gaps for subsequent interventions to improve patient outcomes in this patient population.",

author = "Turpie, {Alexander G G} and Farjat, {Alfredo E} and Sylvia Haas and Walter Ageno and Weitz, {Jeffrey I} and Goldhaber, {Samuel Z} and Shinya Goto and Pantep Angchaisuksiri and Gloria Kayani and Lopes, {Renato D} and Chern-En Chiang and Harry Gibbs and Eric Tse and Peter Verhamme and {Ten Cate}, Hugo and Juan Muntaner and Sebastian Schellong and Henri Bounameaux and Paolo Prandoni and Uma Maheshwari and Kakkar, {Ajay K} and {GARFIELD-VTE Investigators}",

year = "2023",

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day = "1",

doi = "10.1016/j.thromres.2022.11.016",

language = "English",

volume = "222",

pages = "31--39",

journal = "Thrombosis Research",

issn = "0049-3848",

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Turpie, AGG, Farjat, AE, Haas, S, Ageno, W, Weitz, JI, Goldhaber, SZ, Goto, S, Angchaisuksiri, P, Kayani, G, Lopes, RD, Chiang, C-E, Gibbs, H, Tse, E, Verhamme, P, Ten Cate, H, Muntaner, J, Schellong, S, Bounameaux, H, Prandoni, P, Maheshwari, U, Kakkar, AK & GARFIELD-VTE Investigators 2023, '36-month clinical outcomes of patients with venous thromboembolism: Garfield-vte', Thrombosis Research, vol. 222, no. 1, pp. 31-39. https://doi.org/10.1016/j.thromres.2022.11.016

TY - JOUR

T1 - 36-month clinical outcomes of patients with venous thromboembolism

T2 - Garfield-vte

AU - Turpie, Alexander G G

AU - Farjat, Alfredo E

AU - Haas, Sylvia

AU - Ageno, Walter

AU - Weitz, Jeffrey I

AU - Goldhaber, Samuel Z

AU - Goto, Shinya

AU - Angchaisuksiri, Pantep

AU - Kayani, Gloria

AU - Lopes, Renato D

AU - Chiang, Chern-En

AU - Gibbs, Harry

AU - Tse, Eric

AU - Verhamme, Peter

AU - Ten Cate, Hugo

AU - Muntaner, Juan

AU - Schellong, Sebastian

AU - Bounameaux, Henri

AU - Prandoni, Paolo

AU - Maheshwari, Uma

AU - Kakkar, Ajay K

AU - GARFIELD-VTE Investigators

PY - 2023/2/1

Y1 - 2023/2/1

N2 - BACKGROUND: Venous thromboembolism (VTE), encompassing both deep vein thrombosis (DVT) and pulmonary embolism (PE), is a leading cause of morbidity and mortality worldwide.METHODS: GARFIELD-VTE is a prospective, non-interventional observational study of real-world treatment practices. We aimed to capture the 36-month clinical outcomes of 10,679 patients with objectively confirmed VTE enrolled between May 2014 and January 2017 from 415 sites in 28 countries.FINDINGS: A total of 6582 (61.6 %) patients had DVT alone, 4097 (38.4 %) had PE ± DVT. At baseline, 98.1 % of patients received anticoagulation (AC) with or without other modalities of therapy. The proportion of patients on AC therapy decreased over time: 87.6 % at 3 months, 73.0 % at 6 months, 54.2 % at 12 months and 42.0 % at 36 months. At 12-months follow-up, the incidences (95 % confidence interval [CI]) of all-cause mortality, recurrent VTE and major bleeding were 6.5 (7.0-8.1), 5.4 (4.9-5.9) and 2.7 (2.4-3.0) per 100 person-years, respectively. At 36-months, these decreased to 4.4 (4.2-4.7), 3.5 (3.2-2.7) and 1.4 (1.3-1.6) per 100 person-years, respectively. Over 36-months, the rate of all-cause mortality and major bleeds were highest in patients treated with parenteral therapy (PAR) versus oral anti-coagulants (OAC) and no OAC, and the rate of recurrent VTE was highest in patients on no OAC versus those on PAR and OAC. The most frequent cause of death after 36-month follow-up was cancer (n = 565, 48.6 %), followed by cardiac (n = 94, 8.1 %), and VTE (n = 38, 3.2 %). Most recurrent VTE events were DVT alone (n = 564, 63.3 %), with the remainder PE, (n = 236, 27.3 %), or PE in combination with DVT (n = 63, 7.3 %).INTERPRETATION: GARFIELD-VTE provides a global perspective of anticoagulation patterns and highlights the accumulation of events within the first 12 months after diagnosis. These findings may help identify treatment gaps for subsequent interventions to improve patient outcomes in this patient population.

AB - BACKGROUND: Venous thromboembolism (VTE), encompassing both deep vein thrombosis (DVT) and pulmonary embolism (PE), is a leading cause of morbidity and mortality worldwide.METHODS: GARFIELD-VTE is a prospective, non-interventional observational study of real-world treatment practices. We aimed to capture the 36-month clinical outcomes of 10,679 patients with objectively confirmed VTE enrolled between May 2014 and January 2017 from 415 sites in 28 countries.FINDINGS: A total of 6582 (61.6 %) patients had DVT alone, 4097 (38.4 %) had PE ± DVT. At baseline, 98.1 % of patients received anticoagulation (AC) with or without other modalities of therapy. The proportion of patients on AC therapy decreased over time: 87.6 % at 3 months, 73.0 % at 6 months, 54.2 % at 12 months and 42.0 % at 36 months. At 12-months follow-up, the incidences (95 % confidence interval [CI]) of all-cause mortality, recurrent VTE and major bleeding were 6.5 (7.0-8.1), 5.4 (4.9-5.9) and 2.7 (2.4-3.0) per 100 person-years, respectively. At 36-months, these decreased to 4.4 (4.2-4.7), 3.5 (3.2-2.7) and 1.4 (1.3-1.6) per 100 person-years, respectively. Over 36-months, the rate of all-cause mortality and major bleeds were highest in patients treated with parenteral therapy (PAR) versus oral anti-coagulants (OAC) and no OAC, and the rate of recurrent VTE was highest in patients on no OAC versus those on PAR and OAC. The most frequent cause of death after 36-month follow-up was cancer (n = 565, 48.6 %), followed by cardiac (n = 94, 8.1 %), and VTE (n = 38, 3.2 %). Most recurrent VTE events were DVT alone (n = 564, 63.3 %), with the remainder PE, (n = 236, 27.3 %), or PE in combination with DVT (n = 63, 7.3 %).INTERPRETATION: GARFIELD-VTE provides a global perspective of anticoagulation patterns and highlights the accumulation of events within the first 12 months after diagnosis. These findings may help identify treatment gaps for subsequent interventions to improve patient outcomes in this patient population.

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DO - 10.1016/j.thromres.2022.11.016

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SN - 0049-3848

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JO - Thrombosis Research

JF - Thrombosis Research

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