Scientific article
English

Influence of body mass index on clinical outcomes in venous thromboembolism: Insights from GARFIELD-VTE

Published inJournal of thrombosis and haemostasis, vol. 19, no. 12, p. 3031-3043
Publication date2021-12
First online date2021-09-16
Abstract

Background: There is limited information on the influence of body mass index (BMI) on clinical outcomes in patients with venous thromboembolism (VTE).

Objectives: Investigate the influence of BMI on baseline characteristics, treatment patterns, and 24-month outcomes in VTE patients.

Methods: GARFIELD-VTE is a prospective, non-interventional study of 10 869 patients with objectively confirmed VTE. Patients were grouped according to BMI: <18.5 (underweight; n = 214); 18.5-24.9 (normal; n = 2866); 25.0-29.9 (overweight; n = 3326); ≥30 (obese; n = 3073).

Results: Compared with patients with a normal BMI, obese patients were more frequently Caucasian (77.4% vs. 57.9%), treated in the outpatient setting (30.4% vs. 23.1%), and had previous VTE (17.5% vs. 11.7%). Active cancer was associated with lower BMI (underweight: 30.4%, normal: 13.5%, overweight: 9.4%, obese: 7.0%). At baseline, overweight and obese patients less often received parenteral therapy alone (16.7% and 14.4%) compared with those with an underweight or normal BMI (30.8% and 21.6%). Obese patients more commonly remained on anticoagulants for ≥2-years compared to those with a normal BMI (52.3% vs. 37.7%). After 24-months, the risk of all-cause mortality was lower in overweight and obese patients than in those with normal BMI (adjusted hazard ratio [95% CI]; 0.75 [0.63-0.89] and 0.59 [0.49-0.72], respectively). Underweight patients more often experienced major bleeding (2.45 [1.41-4.26]) and all-cause mortality (1.90 [1.43-2.53]) than patients with a normal BMI. Recurrent VTE was comparable among groups.

Conclusion: Underweight VTE patients have the highest risk of mortality and major bleeding. The risk of mortality in obese VTE patients is lower than that in VTE patients with a normal BMI.

Keywords
  • Anticoagulation
  • Body mass index
  • Obesity
  • Pulmonary embolism
  • Venous thromboembolism
  • Anticoagulants / therapeutic use
  • Body Mass Index
  • Hemorrhage
  • Humans
  • Prospective Studies
  • Venous Thromboembolism / diagnosis
Affiliation entities
Funding
  • KANTOR CHARITABLE FOUNDATION -
Citation (ISO format)
WEITZ, Jeffrey I et al. Influence of body mass index on clinical outcomes in venous thromboembolism: Insights from GARFIELD-VTE. In: Journal of thrombosis and haemostasis, 2021, vol. 19, n° 12, p. 3031–3043. doi: 10.1111/jth.15520
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Article (Published version)
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Identifiers
Journal ISSN1538-7836
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Creation23/03/2022 11:39:00
First validation23/03/2022 11:39:00
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