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GARFIELD-VTE Trial for cancer associated DVT and VTE

  • 03
    Mar

     

    By Katherine Kozlowski, Medical Author and Contributor to Vein News and www.VeinsVeinsVeins.com


     

    Cancer associated thrombosis in everyday practice: perspectives from GARFIELD-VTE


    Researchers from the University of Amsterdam proposed a study to examine the prevalence, treatments, and outcomes of cancer patients with venous thromboembolism (VTE), as it is a common cause of morbidity and mortality among cancer patients.

     

    Who was included in the study?


    10,684 patients with objectively diagnosed VTE from 28 countries were observed prospectively.

    1,075 patients had active cancer.

    674 patients had a history of cancer.

    8935 patients had no history or active cancer.

    The median age of each group is 64.8, 68.9, and 58.4 years old, respectively.



    What are the results of the study?


    Patients with active cancers had a higher incidence of upper limb (9.0% vs. 4.8%) and vena cava thrombosis (5.1% vs 1.4%) than cancer-free patients.

    Patients with active cancers were more likely to receive parenteral anticoagulation (directly into the bloodstream), but less likely to receive direct oral anticoagulants (DOACs) than cancer-free patients.

    57.8% of active cancer patients received parenteral anticoagulation vs 12.1% in cancer-free patients.

    Only 14.2% of active cancer patients received DOACs compared to 50.6% in cancer-free patients.

    Death rates, recurrent thromboses, and major bleeding episodes were more prevalent in active cancer patients than cancer-free patients.

    “VTE was the second most common cause of death in patients with active cancer or a history of cancer.”


    What can be concluded from the study?

    Patients who have active cancer and venous thromboembolism have a higher risk of death, recurrent VTE, and major bleeding than those who are cancer-free with VTE.


    Reference: Weitz J., Haas S., Ageno W. et al. Cancer associated thrombosis in everyday practice: perspectives from GARFIELD-VTE. J Thromb 2020; 50(2): 267-277.

     


    Dr Karamanoukian's comment:  Upper extremity DVT is more comon in cancer patients as they may have indwelling catheters for chemotherapy (Mediport, etc).