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The Capital Region of Denmark - a part of Copenhagen University Hospital
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Anticoagulation therapy patterns for acute treatment of venous thromboembolism in GARFIELD-VTE patients

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  • Sylvia Haas
  • Walter Ageno
  • Jeffrey I Weitz
  • Samuel Z Goldhaber
  • Alexander G G Turpie
  • Shinya Goto
  • Pantep Angchaisuksiri
  • Joern Dalsgaard Nielsen
  • Gloria Kayani
  • Audrey Zaghdoun
  • Alfredo E Farjat
  • Sebastian Schellong
  • Henri Bounameaux
  • Lorenzo G Mantovani
  • Paolo Prandoni
  • Ajay K Kakkar
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BACKGROUND: Parenteral anticoagulants and vitamin K antagonists (VKAs) have constituted the cornerstone of venous thromboembolism (VTE) treatment. Meanwhile, direct oral anticoagulants (DOACs) provide physicians with an alternative. The Global Anticoagulant Registry in the FIELD (GARFIELD)-VTE observes real-world treatment practices.

OBJECTIVES: Describe initial anticoagulation (AC) treatment patterns in VTE patients who received parenteral AC, VKAs, and/or DOACs within ±30 days of diagnosis.

METHODS: VTE patients were categorized into parenteral AC only, parenteral AC with transition to VKA, VKA only, parenteral AC with transition to DOAC, and DOAC only.

RESULTS: A total of 9647 patients were initiated on AC treatment alone. 4781 (49.6%) patients received DOACs ± parenteral ACs; 3187 (33.0%), VKA ± parenteral ACs; and 1679 (17.4%) parenteral ACs alone. Rivaroxaban was the most frequently used DOAC (79.4%). DOACs were more frequently used in North America/Australia (58.1%), Europe (52.2%), and Asia (47.6%) than in Latin America (29.7%) and the Middle East/South Africa (32.5%). In patients with suspected VTE, most received parenteral AC monotherapy (67.7%). Patients with deep vein thrombosis were more likely to receive DOACs alone than those with pulmonary embolism with or without deep vein thrombosis (36.2% vs 25.9%). Active cancer patients received parenteral AC alone (58.9%), with 25.5% receiving DOAC ± parenteral AC and 12.8% parenteral AC and VKA. A total of 46.5% of pregnant patients received parenteral AC monotherapy, 34.0% were treated with VKA ± parenteral AC, and 19.5% received a DOAC (± parenteral AC).

CONCLUSION: AC treatment patterns vary by patient population, geographic region and site of VTE. Guidelines for AC therapy are not always adhered to.

Original languageEnglish
JournalJournal of thrombosis and haemostasis : JTH
Volume17
Issue number10
Pages (from-to)1694-1706
Number of pages13
ISSN1538-7933
DOIs
Publication statusPublished - Oct 2019

    Research areas

  • Aged, Aged, 80 and over, Anticoagulants/administration & dosage, Blood Coagulation/drug effects, Drug Utilization/trends, Female, Guideline Adherence/trends, Healthcare Disparities/trends, Humans, Male, Middle Aged, Practice Guidelines as Topic, Practice Patterns, Physicians'/trends, Pregnancy, Pulmonary Embolism/blood, Registries, Time Factors, Treatment Outcome, Venous Thromboembolism/blood, Venous Thrombosis/blood

ID: 61882517