Isolated Distal Deep Vein Thrombosis: Perspectives from the GARFIELD-VTE Registry
- PMID: 31370075
- DOI: 10.1055/s-0039-1693461
Isolated Distal Deep Vein Thrombosis: Perspectives from the GARFIELD-VTE Registry
Erratum in
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Erratum.Thromb Haemost. 2019 Oct;119(10):e1. doi: 10.1055/s-0040-1702204. Epub 2020 May 18. Thromb Haemost. 2019. PMID: 32422665 No abstract available.
Abstract
Isolated distal deep vein thrombosis (IDDVT) represents up to half of all lower limb DVT. This study investigated treatment patterns and outcomes in 2,145 patients with IDDVT in comparison with those with proximal DVT (PDVT; n = 3,846) and pulmonary embolism (PE; n = 4,097) enrolled in the GARFIELD-VTE registry. IDDVT patients were more likely to have recently undergone surgery (14.6%) or experienced leg trauma (13.2%) than PDVT patients (11.0 and 8.7%, respectively) and PE patients (12.7 and 4.5%, respectively). Compared with IDDVT, patients with PDVT or PE were more likely to have active cancer (7.2% vs. 9.9% and 10.3%). However, influence of provoking factors on risk of recurrence in IDDVT remains controversial. Nearly all patients (IDDVT, PDVT, and PE) were given anticoagulant therapy. In IDDVT, PDVT, and PE groups the proportion of patients receiving anticoagulant therapy was 61.4, 73.9, and 81.1% at 6 months and 45.8, 54.7, and 61.9% at 12 months. Over 12 months, the incidence of all-cause mortality, cancer, and recurrence was significantly lower in IDDVT patients than PDVT patients (hazard ratio [HR], 0.61 [95% confidence interval [CI], 0.48-0.77]; sub-HR [sHR], 0.60 [95% CI, 0.39-0.93]; and sHR, 0.76 [95% CI, 0.60-0.97]). Likewise, risk of death and incident cancer was significantly (both p < 0.05) lower in patients with IDDVT compared with PE. This study reveals a global trend that most IDDVT patients as well as those with PDVT and PE are given anticoagulant therapy, in many cases for at least 12 months.
Georg Thieme Verlag KG Stuttgart · New York.
Conflict of interest statement
S.S.: Speaker fees from Bayer Healthcare, Boehringer Ingelheim, Bristol-Myers Squibb, Daiichi-Sankyo, Sanofi Aventis, and Pfizer; consultancy fees from Bayer Healthcare, Boehringer Ingelheim, Daiichi-Sankyo, Sanofi Aventis, Pfizer. S.Z.G.: Grants from BiO2 Medical, Boehringer-Ingelheim, Bristol-Myers Squibb, BTG EKOS, Daiichi-Sankyo, National Heart Lung and Blood Institute of the National Institutes of Health, Janssen, Thrombosis Research Group; personal fees (all consultancy less than $10k) from Bayer, Boehringer-Ingelheim, Bristol-Myers Squibb, Daiichi-Sankyo, Janssen, Portola, Zafgen. J.I.W.: Honoraria from Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, Daiichi-Sankyo, Ionis, Janssen, Merck, Portola, Pfizer, Servier, Novartis. W.A.: Grants and personal fees from Bayer. Personal fees from Boehringer Ingelheim, Daiichi-Sankyo, BMS-Pfizer, Sanofi, Portola, Aspen, Stago, CSL Behring. H.B.: Grants and personal fees from Thrombosis Research Institute, London. Personal fees from Bayer Switzerland. A.G.G.T.: Personal fees from Bayer Pharma AG, Janssen. P.A.: None declared. S.H.: Honoraria from Aspen, Bayer Healthcare, BMS, Daiichi-Sankyo, Pfizer, Portola, Sanofi. S.G.: Research grant from Ono, Bristol-Myers Squibb, Sanofi, Pfizer. A.Z.: None declared. A.F.: None declared. J.D.N.: Honoraria from Bayer, Boehringer-Ingelheim, Bristol-Myers Squibb, Leo Pharma, Pfizer. G.K.: None declared. L.G.M.: Grants and personal fees from Bayer Healthcare, Boehringer Ingelheim, Pfizer, Daiichi-Sankyo. P.P.: Personal fees from Bayer Pharma, Pfizer, Daiichi-Sankyo, Sanofi, Rovi Pharmaceuticos. A.K.K.: Research grants from Bayer Healthcare. Personal fees from Bayer Healthcare, Boehringer-Ingelheim Pharma, Daiichi-Sankyo Europe, Sanofi SA, Janssen Pharma, Verseon Inc., Pfizer.
