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. 2019 Feb;119(2):319-327.
doi: 10.1055/s-0038-1676611. Epub 2018 Dec 28.

Characteristics and Management of Patients with Venous Thromboembolism: The GARFIELD-VTE Registry

Walter Ageno  1 , Sylvia Haas  2 , Jeffrey I Weitz  3 , Samuel Z Goldhaber  4 , Alexander G G Turpie  5 , Shinya Goto  6 , Pantep Angchaisuksiri  7 , Joern Dalsgaard Nielsen  8 , Gloria Kayani  9 , Karen S Pieper  10 , Sebastian Schellong  11 , Henri Bounameaux  12 , Lorenzo G Mantovani  13 , Paolo Prandoni  14 , Ajay K Kakkar  15 ; GARFIELD-VTE investigators
Affiliations

Characteristics and Management of Patients with Venous Thromboembolism: The GARFIELD-VTE Registry

Walter Ageno et al. Thromb Haemost. 2019 Feb.

Abstract

Background: Management of venous thromboembolism (VTE), encompassing both deep vein thrombosis (DVT) and pulmonary embolism (PE), varies worldwide.

Methods: The Global Anticoagulant Registry in the FIELD - Venous Thromboembolism (GARFIELD-VTE) is a prospective, observational study of 10,685 patients with objectively diagnosed VTE recruited from May 2014 to January 2017 at 417 sites in 28 countries. All patients are followed for at least 3 years. We describe the baseline characteristics of the study population and their management within 30 days of diagnosis.

Results: The median age was 60.2 years; 50.4% were male; 61.7% had DVT and 38.3% had PE ± DVT; and 32.3% were obese (body mass index ≥ 30 kg/m2). The most common risk factors were surgery (12.5%), hospitalization (12.0%) and trauma to the lower limbs (7.8%). At the time of VTE diagnosis, 10.1% had active cancer and 5.7% were chronically immobilized. Treatment for VTE was anticoagulant (AC) therapy alone in 90.9% of patients; 5.1% received thrombolytic and/or surgical/mechanical therapy ± AC and 4.0% received no therapy. Pre-diagnosis, 12.8% received AC therapy alone and 0.2% received thrombolytic and/or surgical/mechanical therapy ± AC. After diagnosis, parenteral AC therapy alone was administered in 17.6% of patients, and it was followed by a direct oral AC (DOAC) in 16.4% or a vitamin K antagonist (VKA) in 26.8%. DOACs alone were prescribed to 32.3% of patients, while 5.9% received VKA alone.

Conclusion: The initial findings from this global registry highlight the heterogeneity in characteristics and management of VTE patients. Prospective follow-up will reveal the impact of this heterogeneity on outcomes.

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Conflict of interest statement

Walter Ageno: Honoraria from Boehringer Ingelheim, Bayer Pharmaceuticals, BMS-Pfizer and Daiichi-Sankyo. Research support from Bayer Pharmaceuticals and Boehringer Ingelheim. Sylvia Haas: Honoraria from Aspen, Bayer Healthcare, BMS, Daiichi-Sankyo, Pfizer, Portola and Sanofi. Jeffrey I. Weitz: Honoraria from Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Daiichi-Sankyo, Ionis, Janssen, Merck, Portola, Pfizer, Servier and Novartis. Samuel Z. Goldhaber: Grants from BiO2 Medical, Boehringer Ingelheim, Bristol Meyers Squibb, BTG EKOS, Daiichi-Sankyo, National Heart Lung and Blood Institute of the National Institutes of Health, Janssen and the Thrombosis Research Group. Personal fees (all consultancy less than $10K) from Bayer, Boehringer Ingelheim, Bristol Meyers Squibb, Daiichi-Sankyo, Janssen, Portola and Zafgen. Alexander G. G. Turpie: Personal fees from Bayer Pharma AG and Janssen. Shinya Goto: Honoraria from Sanofi, AstraZeneca and Bayer. Research funding from Sanofi. Sebastian Schellong: Speaker fees from Bayer Healthcare, Boehringer Ingelheim, Bristol Meyer Squibb, Daiichi-Sankyo, Sanofi Aventis and Pfizer. Consultancy fees from Bayer Healthcare, Boehringer Ingelheim, Daiichi-Sankyo, Sanofi Aventis and Pfizer. Joern Dalsgaard Nielsen: Honoraria from Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Leo Pharma and Pfizer. Henri Bounameaux: Research grant, speaker's fees and honoraria for studies with rivaroxaban from Bayer Healthcare. Honoraria from Sanofi. Lorenzo Mantovani: Grants and personal fees from Bayer Healthcare, Boehringer Ingelheim, Pfizer and Daiichi-Sankyo. Paolo Prandoni: Personal fees from Bayer Pharma, Pfizer, Daiichi-Sankyo, Sanofi and Rovi Pharmaceuticos. Professor Ajay K. Kakkar is a principal investigator and received research Grants from Bayer Healthcare; he received personal fee from Bayer Healthcare, Boehringer Ingelheim Pharma, Daiichi-Sankyo Europe, Sanofi SA and Janssen Pharma. Pantep Angchaisuksiri, Karen Pieper and Gloria Kayani declare that they have no conflicts of interest in the research.