The influence of anemia on clinical outcomes in venous thromboembolism: Results from GARFIELD-VTE
|Published in||Thrombosis research. 2021, vol. 203, p. 155-162|
Introduction: Clinical characteristics and outcomes of venous thromboembolism (VTE) patients with concomitant anemia are unclear. This study compares baseline characteristics, treatment patterns, and 24-month outcomes in patients with and without anemia within GARFIELD-VTE.
Materials and methods: GARFIELD-VTE (ClinicalTrials.gov: <a href="http://clinicaltrials.gov/show/NCT02155491" rel="noopener noreferrer" target="_blank">NCT02155491</a>) is a global, prospective, non-interventional registry of real-world treatment practices. Of the 10,679 patients enrolled in GARFIELD-VTE, 7698 were eligible for analysis. Primary outcomes were all-cause mortality, recurrent VTE, and major bleeding in VTE patients with or without concomitant anemia over 24-months after diagnosis. Event rates and 95% confidence intervals were estimated using Poisson regression. Adjusted hazard ratios were calculated using Cox proportional hazard models.
Results: Distribution of VTE events in 2771 patients with anemia and 4927 without anemia was similar (deep-vein thrombosis alone: 61·1% vs. 55·9%, pulmonary embolism ± deep vein thrombosis: 38·9% vs. 44·0%, respectively). Patients with anemia were older (62.6 year vs. 58.9 years) than those without. At baseline, VTE risk factors that were more common in patients with anemia included hospitalization (22·0% vs. 6·8%), surgery (19·2% vs. 8·2%), cancer (20·1% vs. 5·6%) and acute medical illness (8·3% vs. 4·2%). Patients with anemia were more likely to receive parenteral anticoagulation therapy alone than those without anemia (26·6% vs. 11·7%) and less likely to receive a direct oral anticoagulant (38·5% vs. 53·5%). During 24-months of follow-up, patients with anemia had a higher risk (adjusted hazard ratio [95% confidence interval]) of all-cause mortality (1·84 [1·56-2·18]), major bleeding (2·83 [2·14-3·75]). Among anemia patients, the risk of all-cause mortality and major bleeding remained higher in patients with severe anemia than in those with mild/moderate anemia, all-cause mortality: HR 1·43 [95% CI: 1·21-1·77]; major bleeding: HR 2·08 [95% CI: 1·52-2·86]).
Conclusions: VTE patients with concomitant anemia have a higher risk of adverse clinical outcomes compared with those without anemia. Further optimization of anticoagulation therapy for VTE patients with anemia is warranted.
|Keywords||Anemia — Anticoagulation — Deep vein thrombosis — Pulmonary embolism — Venous thromboembolism — Anemia / complications — Anticoagulants / therapeutic use — Humans — Prospective Studies — Pulmonary Embolism — Venous Thromboembolism / complications|
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Other version: https://www.sciencedirect.com/science/article/pii/S0049384821003285
|Research group||La maladie thromboembolique veineuse (808)|
|GOTO, Shinya et al. The influence of anemia on clinical outcomes in venous thromboembolism: Results from GARFIELD-VTE. In: Thrombosis research, 2021, vol. 203, p. 155-162. doi: 10.1016/j.thromres.2021.05.007 https://archive-ouverte.unige.ch/unige:161627|