TY - JOUR
T1 - Upper Extremity DVT versus Lower Extremity DVT
T2 - Perspectives from the GARFIELD-VTE Registry
AU - Ageno, Walter
AU - Haas, Sylvia
AU - Weitz, Jeffrey I
AU - Goldhaber, Samuel Z
AU - Turpie, Alexander G G
AU - Goto, Shinya
AU - Angchaisuksiri, Pantep
AU - Dalsgaard Nielsen, Joern
AU - Kayani, Gloria
AU - Farjat, Alfredo E
AU - Zaghdoun, Audrey
AU - Schellong, Sebastian
AU - Bounameaux, Henri
AU - Mantovani, Lorenzo G
AU - Prandoni, Paolo
AU - Darius, Harald
AU - Kakkar, Ajay K
N1 - Georg Thieme Verlag KG Stuttgart · New York.
PY - 2019/8
Y1 - 2019/8
N2 - Upper extremity deep vein thrombosis (UEDVT) is less common than lower extremity DVT (LEDVT) and consequently less well characterized. This study compared clinical characteristics and 1-year outcomes between 438 UEDVT patients and 7,602 LEDVT patients recruited in the GARFIELD-VTE registry. UEDVT patients were significantly more likely to have a central venous catheter than those with LEDVT (11.5% vs. 0.5%; p < 0.0001), and had a higher rate of active cancer (16.2%) or recent hospitalization (19.4%) compared with LEDVT patients (8.7% and 11.2%, respectively). Nearly all patients with UEDVT and LEDVT were initiated on anticoagulant therapy, which was a direct oral anticoagulant in one-third individuals in both groups. At 3, 6, and 12 months, the proportion of UEDVT and LEDVT patients who were receiving anticoagulant therapy was 82.6 and 87.4%, 66.0 and 72.6%, and 45.7 and 54.6%, respectively. In the UEDVT and LEDVT groups, VTE recurrence rate was 4.0 (95% confidence interval [CI], 2.4-6.7) and 5.5 (95% CI, 4.9-6.1) per 100 person-years, respectively; major bleed was noted in 1.3 (95% CI, 0.6-3.2) and 1.6 (95% CI, 1.3-1.9) per 100 person-years and all-cause mortality in 9.7 (95% CI, 7.1-13.4) and 6.7 (95% CI, 6.1-7.3) per 100 person-years, respectively. Hence, risk of recurrence was similar in the two groups whereas all-cause mortality was significantly higher in the UEDVT group than the LEDVT group (p = 0.0338). This latter finding was likely due to the high prevalence of cancer in the UEDVT group.
AB - Upper extremity deep vein thrombosis (UEDVT) is less common than lower extremity DVT (LEDVT) and consequently less well characterized. This study compared clinical characteristics and 1-year outcomes between 438 UEDVT patients and 7,602 LEDVT patients recruited in the GARFIELD-VTE registry. UEDVT patients were significantly more likely to have a central venous catheter than those with LEDVT (11.5% vs. 0.5%; p < 0.0001), and had a higher rate of active cancer (16.2%) or recent hospitalization (19.4%) compared with LEDVT patients (8.7% and 11.2%, respectively). Nearly all patients with UEDVT and LEDVT were initiated on anticoagulant therapy, which was a direct oral anticoagulant in one-third individuals in both groups. At 3, 6, and 12 months, the proportion of UEDVT and LEDVT patients who were receiving anticoagulant therapy was 82.6 and 87.4%, 66.0 and 72.6%, and 45.7 and 54.6%, respectively. In the UEDVT and LEDVT groups, VTE recurrence rate was 4.0 (95% confidence interval [CI], 2.4-6.7) and 5.5 (95% CI, 4.9-6.1) per 100 person-years, respectively; major bleed was noted in 1.3 (95% CI, 0.6-3.2) and 1.6 (95% CI, 1.3-1.9) per 100 person-years and all-cause mortality in 9.7 (95% CI, 7.1-13.4) and 6.7 (95% CI, 6.1-7.3) per 100 person-years, respectively. Hence, risk of recurrence was similar in the two groups whereas all-cause mortality was significantly higher in the UEDVT group than the LEDVT group (p = 0.0338). This latter finding was likely due to the high prevalence of cancer in the UEDVT group.
KW - Administration, Oral
KW - Adolescent
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Anticoagulants/administration & dosage
KW - Catheterization, Central Venous
KW - Female
KW - Hospitalization
KW - Humans
KW - Lower Extremity/physiopathology
KW - Male
KW - Middle Aged
KW - Prevalence
KW - Prospective Studies
KW - Recurrence
KW - Registries
KW - Upper Extremity/physiopathology
KW - Venous Thrombosis/complications
KW - Young Adult
U2 - 10.1055/s-0039-1688828
DO - 10.1055/s-0039-1688828
M3 - Journal article
C2 - 31183844
SN - 0340-6245
VL - 119
SP - 1365
EP - 1372
JO - Thrombosis and Haemostasis
JF - Thrombosis and Haemostasis
IS - 8
ER -