ISTH Academy

PB1114

Venous Thromboembolism in Asia and Worldwide: Emerging Insights from GARFIELD-VTE

P. Angchaisuksiri¹, S.-M. Bang², H. Fryk³, C.-E. Chiang⁴, Z.-C. Jing⁵, S. Wang⁶, K. Kondo⁷, J. Sathar⁸, E. Tse⁹, S. Goto¹⁰, A. Kakkar³, on behalf of the GARFIELD-VTE Investigators
¹Division of Hematology, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand, ²Seoul National University, Bundang Hospital Seongnam, Department of Internal Medicine, Korea, United Kingdom, ³Thrombosis Research Institute, London, United Kingdom, ⁴Division of Cardiology, Taipei Veterans General Hospital and National Yang-Ming University, General Clinical Research Center, Taipei, Taiwan, Republic of China, ⁵FuWai Hospital, National Center for Cardiovascular Disease, Peking Union Medical College & Chinese Academy of Medical Sciences, State Key Lab of Cardiovascular Disease, Beijing, China, ⁶The First Affiliated Hospital of Sun Yat-sen University, Division of Vascular Surgery, Guangzhou, China, ⁷Kokura Memorial Hospital, Department of Cardiology, Kitakyushu, Japan, ⁸Ampang Hospital, Department of Haematology, Selangor, Malaysia, ⁹University of Hong Kong, Queen Mary Hospital, Department of Medicine, Pok Fu Lam, Hong Kong, ¹⁰Tokai University School of Medicine, Department of Medicine (Cardiology), Tokai, Japan

Main Topic: Venous Thromboembolism
Category: VTE Therapy

Background: Although the incidence of venous thromboembolism (VTE) in Asia has been reported to be lower than that of the Western world, its prevalence is increasing and has become a major health concern in several Asian countries.
Aims: Compare the baseline characteristics, treatment patterns, 12-month outcomes and cause of death in VTE patients from Asia with those from the rest of the world, enrolled in the Global Anticoagulant Registry in the FIELD (GARFIELD)-VTE.
Methods: GARFIELD-VTE (ClinicalTrials.gov: NCT02155491) is a global, prospective, non-interventional study of real-world treatment practices. 10,685 patients with objectively confirmed VTE were enrolled between May 2014 and January 2017. 1,822 (17.1%) were from Asia (China n=420, Hong Kong n=98, Japan n=148, Malaysia n=244, South Korea n=343, Taiwan n=232, Thailand n=337).
Results: 62.2% of Asian patients had deep vein thrombosis (DVT), 37.8% had pulmonary embolism ± DVT. Asian patients (vs non-Asian) were more often female (57.4% vs. 48.0%), non-smokers (74.0% vs 58.9%), older; mean age (standard deviation) 59 (16.7) years vs. 57 (17.0) years, and had a lower BMI; mean (standard deviation) 24.8 (5.0) kg/m² vs 29.1 (6.6) kg/m². Asian patients were more often managed in the hospital setting (86.9% vs 70.4%), and were more likely to have active cancer (19.6% vs. 7.9%) or a history of cancer (18.9 vs. 12.0%). Hospitalization (17.0%) and surgery (13.4%) were the most common provoking factors. Asian patients most frequently received a direct oral anticoagulant alone (31.4%) or parenteral therapy alone (23.3%) (Table 1). Over 12-months follow-up, rates (95% confidence intervals) of all-cause mortality, major bleed, and recurrent VTE in Asians (vs non-Asians) were: 15.0 (13.2-17.1) vs. 5.9 (5.4-6.4), 2.4 (1.7-3.3) vs. 1.7 (1.4-2.0), and 5.6 (4.5-7.0) vs. 5.1 (4.6-5.6) per 100 person-years, respectively (Table 2).
Conclusions: Asian and non-Asian patients have different risk profiles which may contribute to differences in outcomes.