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Upper Extremity DVT versus Lower Extremity DVT: Perspectives from the GARFIELD-VTE Registry.

  • Ageno W Department of Medicine and Surgery, University of Insubria, Varese, Italy.
  • Haas S Department of Medicine, Technical University of Munich, Munich, Germany.
  • Weitz JI Thrombosis and Atherosclerosis Research Institute, McMaster University, Hamilton, Ontario, Canada.
  • Goldhaber SZ Harvard Medical School, Harvard University, Boston, Massachusetts, United States.
  • Turpie AGG Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
  • Goto S Department of Medicine (Cardiology), Tokai University School of Medicine, Tokyo, Japan.
  • Angchaisuksiri P Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
  • Dalsgaard Nielsen J Copenhagen University Hospital, Copenhagen, Denmark.
  • Kayani G Thrombosis Research Institute, London, United Kingdom.
  • Farjat AE Thrombosis Research Institute, London, United Kingdom.
  • Zaghdoun A Thrombosis Research Institute, London, United Kingdom.
  • Schellong S Medical Division 2, Municipal Hospital Dresden-Friedrichstadt, Dresden, Germany.
  • Bounameaux H Faculty of Medicine, University Hospitals of Geneva, Geneva, Switzerland.
  • Mantovani LG Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy.
  • Prandoni P Arianna Foundation on Anticoagulation, Bologna, Italy.
  • Darius H Vivantes Neukoelln Medical Center, Berlin, Germany.
  • Kakkar AK Thrombosis Research Institute and University College London, London, United Kingdom.
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  • 2019-06-12
Published in:
  • Thrombosis and haemostasis. - 2019
Administration, Oral
Adolescent
Adult
Aged
Aged, 80 and over
Anticoagulants
Catheterization, Central Venous
Female
Hospitalization
Humans
Lower Extremity
Male
Middle Aged
Prevalence
Prospective Studies
Recurrence
Registries
Upper Extremity
Venous Thrombosis
Young Adult
English 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.
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  • English
Open access status
green
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Persistent URL
https://folia.unifr.ch/global/documents/293248
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