Venous thromboembolism in Asia and worldwide: Emerging insights from GARFIELD-VTE

Angchaisuksiri P 1 , Goto S 2 , Farjat AE 3 , Fryk H 3 , Bang SM 4 , Chiang CE 5 Show all authors , Jing ZC 6 , Kondo K 7 , Sathar J 8 , Tse E 9 , Phusanti S 10 , Kayani G 3 , Weitz JI 11 , Ageno W 12 , Goldhaber SZ 13 , Kakkar AK 14

Affiliations 

  • 1 Division of Hematology, Department of Medicine, Ramathibodi Hospital, Mahidol University, Thailand. Electronic address: pantep.ang@mahidol.ac.th
  • 2 Department of Medicine (Cardiology), Tokai University School of Medicine, Japan
  • 3 Thrombosis Research Institute, London, United Kingdom
  • 4 Division of Hematology-Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, South Korea
  • 5 General Clinical Research Center, Division of Cardiology, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan
  • 6 Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
  • 7 Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan
  • 8 Department of Haematology, Ampang hospital, Selangor, Malaysia
  • 9 Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong
  • 10 Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand
  • 11 McMaster University and the Thrombosis and Atherosclerosis Research Institute, Hamilton, Ontario, Canada
  • 12 Department of Medicine and Surgery, University of Insubria, Varese, Italy
  • 13 Brigham and Women's Hospital and Harvard Medical School, Boston, USA
  • 14 Thrombosis Research Institute, London, United Kingdom; University College London, London, United Kingdom
Thromb Res, 2021 05;201:63-72.
PMID: 33652328 DOI: 10.1016/j.thromres.2021.02.024

Abstract

BACKGROUND: Although epidemiological studies report a lower risk of venous thromboembolism (VTE) than in the Western world, VTE rates in Asia may be underestimated. Furthermore, it is uncertain whether VTE outcomes differ in Asia and the rest of the world (ROW).

METHODS: GARFIELD-VTE is a global, prospective, non-interventional study of real-world treatment practices. In this study, we compared baseline characteristics, treatment patterns, and 12-month outcomes in Asia and ROW.

RESULTS: Of the 10,684 enrolled patients, 1822 (17.1%) were Asian (China n = 420, Hong Kong n = 98, Japan n = 148, Malaysia n = 244, South Korea n = 343, Taiwan n = 232, Thailand n = 337). Compared with ROW patients, those from Asia were more often female (57.4% vs. 48.0%), non-smokers (74.0% vs. 58.9%) and had a lower BMI (24.8 kg/m2 vs. 29.1 kg/m2). Asian patients were more likely to be managed in the hospital (86.9% vs. 70.4%) and to have active cancer (19.8% vs. 8.1%) or a history of cancer (19.1% vs. 12.0%). Asian patients received no anticoagulation more frequently than ROW patients (6.5% vs. 2.1%). Over 12-months follow-up, the rate of all-cause mortality (per 100 person-years [95% confidence interval]) was higher in Asians (15.2 [13.4-17.3] vs. 5.9 [5.4-6.5]). Adjusted hazard ratios indicated a higher risk of all-cause mortality in Asian patients than the ROW (1.32 [1.08-1.62]). The frequencies of major bleeding and recurrent VTE were similar.

CONCLUSION: Asian patients have different risk profiles, treatment patterns and a higher risk of mortality compared with the ROW.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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