TY - JOUR
T1 - Cancer associated thrombosis in everyday practice
T2 - perspectives from GARFIELD-VTE
AU - the GARFIELD-VTE investigators
AU - Weitz, Jeffrey I.
AU - Haas, Sylvia
AU - Ageno, Walter
AU - Goldhaber, Samuel Z.
AU - Turpie, Alexander G.G.
AU - Goto, Shinya
AU - Angchaisuksiri, Pantep
AU - Nielsen, Jørn Dalsgaard
AU - Kayani, Gloria
AU - Farjat, Alfredo E.
AU - Schellong, Sebastian
AU - Bounameaux, Henri
AU - Mantovani, Lorenzo G.
AU - Prandoni, Paolo
AU - Kakkar, Ajay K.
AU - Loualidi, Ab
AU - Colak, Abdurrahim
AU - Bezuidenhout, Abraham
AU - Abdool-Carrim, Abu
AU - Azeddine, Addala
AU - Beyers, Adriaan
AU - Dees, Adriaan
AU - Mohamed, Ahmed
AU - Aksoy, Ahmet
AU - Abiko, Akihiko
AU - Watanabe, Akinori
AU - Krichell, Alan
AU - Fernandez, Alberto Alfredo
AU - Tosetto, Alberto
AU - Khotuntsov, Alexey
AU - Oropallo, Alisha
AU - Slocombe, Alison
AU - Kelly, Allan
AU - Clark, Amanda
AU - Gad, Amr
AU - Arouni, Amy
AU - Schmidt, Andor
AU - Berni, Andrea
AU - Kleiban, Andres Javier
AU - Machowski, Andrew
AU - Kazakov, Andrey
AU - Galvez, Angel
AU - Lockman, Ann
AU - Falanga, Anna
AU - Chauhan, Anoop
AU - Riera-Mestre, Antoni
AU - Mazzone, Antonino
AU - D’Angelo, Armando
AU - Herdy, Artur
AU - Mun, Yeung Chul
N1 - Publisher Copyright:
© 2020, Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2020/8/1
Y1 - 2020/8/1
N2 - Venous thromboembolism (VTE) is common in cancer patients and is an important cause of morbidity and mortality. The Global Anticoagulant Registry in the FIELD (GARFIELD)–VTE (ClinicalTrials.gov: NCT02155491) is a prospective, observational study of 10,684 patients with objectively diagnosed VTE from 415 sites in 28 countries. We compared baseline characteristics, VTE treatment patterns, and 1-year outcomes (mortality, recurrent VTE and major bleeding) in 1075 patients with active cancer, 674 patients with a history of cancer, and 8935 patients without cancer. Patients with active cancer and history of cancer were older than cancer-free patients, with median ages of 64.8, 68.9, and 58.4 years, respectively. The most common sites of active cancer were lung (14.5%), colorectal (11.0%), breast (10.6%), and gynaecological (10.3%). Active cancer patients had a higher incidence of upper limb and vena cava thrombosis than cancer-free patients (9.0% vs 4.8% and 5.1% vs 1.4%, respectively), and were more likely to receive parenteral anticoagulation as monotherapy than cancer-free patients (57.8% vs 12.1%), and less likely to receive DOACs (14.2% vs 50.6%). Rates of death, recurrent VTE, and major bleeding were higher in active cancer patients than in cancer-free patients, with hazard ratios (95% confidence intervals) of 14.2 (12.1–16.6), 1.6 (1.2–2.0) and 3.8 (2.9–5.0), respectively. VTE was the second most common cause of death in patients with active cancer or history of cancer. In patients with VTE, those with active cancer are at higher risk of death, recurrence, and major bleeding than those without cancer.
AB - Venous thromboembolism (VTE) is common in cancer patients and is an important cause of morbidity and mortality. The Global Anticoagulant Registry in the FIELD (GARFIELD)–VTE (ClinicalTrials.gov: NCT02155491) is a prospective, observational study of 10,684 patients with objectively diagnosed VTE from 415 sites in 28 countries. We compared baseline characteristics, VTE treatment patterns, and 1-year outcomes (mortality, recurrent VTE and major bleeding) in 1075 patients with active cancer, 674 patients with a history of cancer, and 8935 patients without cancer. Patients with active cancer and history of cancer were older than cancer-free patients, with median ages of 64.8, 68.9, and 58.4 years, respectively. The most common sites of active cancer were lung (14.5%), colorectal (11.0%), breast (10.6%), and gynaecological (10.3%). Active cancer patients had a higher incidence of upper limb and vena cava thrombosis than cancer-free patients (9.0% vs 4.8% and 5.1% vs 1.4%, respectively), and were more likely to receive parenteral anticoagulation as monotherapy than cancer-free patients (57.8% vs 12.1%), and less likely to receive DOACs (14.2% vs 50.6%). Rates of death, recurrent VTE, and major bleeding were higher in active cancer patients than in cancer-free patients, with hazard ratios (95% confidence intervals) of 14.2 (12.1–16.6), 1.6 (1.2–2.0) and 3.8 (2.9–5.0), respectively. VTE was the second most common cause of death in patients with active cancer or history of cancer. In patients with VTE, those with active cancer are at higher risk of death, recurrence, and major bleeding than those without cancer.
KW - Anticoagulation
KW - Cancer
KW - Malignancy
KW - Registry
KW - Venous thromboembolism
UR - http://www.scopus.com/inward/record.url?scp=85086853155&partnerID=8YFLogxK
U2 - 10.1007/s11239-020-02180-x
DO - 10.1007/s11239-020-02180-x
M3 - Article
C2 - 32583306
AN - SCOPUS:85086853155
SN - 0929-5305
VL - 50
SP - 267
EP - 277
JO - Journal of Thrombosis and Thrombolysis
JF - Journal of Thrombosis and Thrombolysis
IS - 2
ER -