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Ageno W, Farjat A, Haas S, et al. Provoked versus unprovoked venous thromboembolism: Findings from GARFIELD-VTE. Res Pract Thromb Haemost. 2021;5(2):326-341doi: 10.1002/rth2.12482.
Ageno, W., Farjat, A., Haas, S., Weitz, J. I., Goldhaber, S. Z., Turpie, A. G. G., Goto, S., Angchaisuksiri, P., Dalsgaard Nielsen, J., Kayani, G., Schellong, S., Bounameaux, H., Mantovani, L. G., Prandoni, P., & Kakkar, A. K. (2021). Provoked versus unprovoked venous thromboembolism: Findings from GARFIELD-VTE. Research and practice in thrombosis and haemostasis, 5(2), 326-341. https://doi.org/10.1002/rth2.12482
Ageno, Walter, et al. "Provoked versus unprovoked venous thromboembolism: Findings from GARFIELD-VTE." Research and practice in thrombosis and haemostasis vol. 5,2 (2021): 326-341. doi: https://doi.org/10.1002/rth2.12482
Ageno W, Farjat A, Haas S, Weitz JI, Goldhaber SZ, Turpie AGG, Goto S, Angchaisuksiri P, Dalsgaard Nielsen J, Kayani G, Schellong S, Bounameaux H, Mantovani LG, Prandoni P, Kakkar AK. Provoked versus unprovoked venous thromboembolism: Findings from GARFIELD-VTE. Res Pract Thromb Haemost. 2021 Feb 20;5(2):326-341. doi: 10.1002/rth2.12482. eCollection 2021 Feb. PMID: 33733032; PMCID: PMC7938631.
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Res Pract Thromb Haemost. 2021 Feb 20;5(2):326-341. doi: 10.1002/rth2.12482. eCollection 2021 Feb.

Provoked versus unprovoked venous thromboembolism: Findings from GARFIELD-VTE.

Research and practice in thrombosis and haemostasis

Walter Ageno, Alfredo Farjat, Sylvia Haas, Jeffrey I Weitz, Samuel Z Goldhaber, Alexander G G Turpie, Shinya Goto, Pantep Angchaisuksiri, Joern Dalsgaard Nielsen, Gloria Kayani, Sebastian Schellong, Henri Bounameaux, Lorenzo G Mantovani, Paolo Prandoni, Ajay K Kakkar

Affiliations

  1. Department of Medicine and Surgery University of Insubria Varese Italy.
  2. Thrombosis Research Institute London UK.
  3. Formerly Technical University of Munich Munich Germany.
  4. McMaster University and the Thrombosis and Atherosclerosis Research Institute Hamilton ON Canada.
  5. Brigham and Women's Hospital and Harvard Medical School Boston MA USA.
  6. McMaster University Hamilton ON Canada.
  7. Department of Medicine (Cardiology) Tokai University School of Medicine Shibuya City Japan.
  8. Department of Medicine Ramathibodi Hospital, Mahidol University Nakhon Pathom Thailand.
  9. Copenhagen University Hospital Copenhagen Denmark.
  10. Medical Department 2 Municipal Hospital Dresden Dresden Germany.
  11. Faculty of Medicine Geneva Switzerland.
  12. IRCCS Multimedica Milan Italy.
  13. University of Milano Milan Italy.
  14. Arianna Foundation on Anticoagulation Bologna Italy.
  15. University College London London UK.

PMID: 33733032 PMCID: PMC7938631 DOI: 10.1002/rth2.12482

Abstract

INTRODUCTION: Venous thromboembolism (VTE) has a long-term risk of recurrence, dependent on the presence or absence of provoking risk factors at the time of the event.

OBJECTIVE: To compare clinical characteristics, anticoagulant patterns, and 12-month outcomes in patients with transient provoking factors, active cancer, and unprovoked VTE.

METHODS: The Global Anticoagulant Registry in the FIELD (GARFIELD)-VTE is a prospective, observational study that enrolled 10 207 patients with objectively diagnosed VTE from 415 sites in 28 countries.

RESULTS: Patients with transient provoking factors were younger (53.0 years) and more frequently women (61.2%) than patients with unprovoked VTE (60.3 years; 43.0% women) or active cancer (63.6 years; 51.7% women). After 6 months, 59.1% of patients with transient provoking factors remained on anticoagulation, compared to 71.3% with unprovoked VTE and 47.3% with active cancer. At 12 months, this decreased to 36.7%, 51.5%, and 25.4%, respectively. The risk of mortality (hazard ratio [HR], 1.21; 95% confidence interval [CI], 0.90-1.62), recurrent VTE (HR, 0.84; 95% CI, 0.62-1.14), and major bleeding (HR, 1.26; 95% CI, 0.86-1.85) was comparable in patients with transient provoking factors and unprovoked VTE. Patients with minor and major transient provoking factors had a similar risk of recurrent VTE (HR, 0.99; 95% CI, 0.59-1.66), but those with major transient risk factors had a lower risk of death (HR, 0.61; 95% CI, 0.38-0.98).

CONCLUSION: At 1 year, nearly 40% of patients with transient provoking factors and slightly over half of patients with unprovoked VTE were on anticoagulant treatment. Event rates were comparable between the two groups. Risk of death was higher in patients with minor transient factors than in those with major transient factors.

© 2021 The Authors. Research and Practice in Thrombosis and Haemostasis published by Wiley Periodicals LLC on behalf of International Society on Thrombosis and Haemostasis (ISTH).

Keywords: anticoagulants; deep vein thrombosis; pulmonary embolism; risk factors; venous thromboembolism

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