Cancer associated thrombosis in everyday practice: perspectives from GARFIELD-VTE
Adult
Male
Registry
Time Factors
2720 Hematology
Hemorrhage
Anticoagulation; Cancer; Malignancy; Registry; Venous thromboembolism
Risk Assessment
2705 Cardiology and Cardiovascular Medicine
PROPHYLAXIS
Anticoagulation
03 medical and health sciences
0302 clinical medicine
SDG 3 - Good Health and Well-being
Fibrinolytic Agents
Recurrence
Risk Factors
Cause of Death
Neoplasms
MANAGEMENT
Humans
DEEP-VEIN THROMBOSIS
Prospective Studies
Registries
Cancer
Aged
Aged, 80 and over
VENOUS THROMBOEMBOLISM
Anticoagulation; Cancer; Malignancy; Registry; Venous thromboembolism.
Malignancy
Anticoagulants
Middle Aged
3. Good health
Treatment Outcome
REGISTRY
RISK-FACTORS
Female
CLINICAL-PRACTICE GUIDELINES
Pulmonary Embolism
Venous thromboembolism
DOI:
10.1007/s11239-020-02180-x
Publication Date:
2020-06-24T19:02:38Z
AUTHORS (475)
ABSTRACT
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.
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