Abstract Number: PB2448
Meeting: ISTH 2020 Congress
Theme: Venous Thromboembolism and Cardioembolism » VTE Treatment
Background: Upper extremity deep venous thrombosis (UEDVT) is rare, and typically associated with cancer and central venous catheters (CVCs). Risk factors, management and outcomes of UEDVT outside the context of cancer and CVCs are not well characterized.
Aims: Compare the clinical characteristics, risk factors, management and outcomes of patients with UEDVT not associated with cancer or CVC, with those of patients with non-cancer, non-CVC associated lower extremity DVT (LEDVT) enrolled in the Survey on anticoagulaTed pAtients RegisTer (START2-Register).
Methods: The START2-Register (ClinicalTrials.gov Identifier: NCT02219984) is an observational, multicenter, prospective cohort study that includes adult patients (>18 years) who start anticoagulation therapy for various indications. Patients with cancer, history of cancer and CVCs were excluded from analysis. Of the 6,835 patients enrolled in the register, for the purpose of this analysis 2,174 patients were included for whom data were collected between September 2010 and November 2019.
Results: Eighty nine patients with UEDVT were compared with 2,085 patients with LEDVT. Patients with UEDVT were significantly younger (51.7 vs. 63.3 years, p-value< 0.0001) and were more likely to receive extended parenteral anticoagulant treatment with LMWH (6.7% vs. 1.9%, p-value=0.002). There was a trend towards preferring oral treatment with VKAs (57.3% vs. 52%, p-value=0.33) rather than with DOACs in patients with UEDVT as compared to patients with LEDVT (36% vs. 46.1%, p-value=0.06) (Table 1).
After a median follow-up of 12.2 months (IQR 5.9-25.1 months), all-cause mortality rates (incidence rate 4.6 vs. 2.5 per 100 person-years, HR 2.1, 95% CI 0.8-5.8) and arterial events rates (incidence rate 1.1 vs. 0.4 per 100 person-years, HR 3.3, 95% CI 0.4-25.5) were non-significantly higher in UEDVT patients than in LEDVT patients (Figure 1).
Conclusions: Outside the context of cancer and CVCs, patients with UEDVT are younger, and show a tendency towards higher all-cause mortality and arterial event rates than LEDVT patients.
| All patients | LEDVT | UEDVT | P-value | |||||
| N | 2174 | 2085 | 89 | |||||
| Follow-up (months) | Median (range) | 12.2 | (0-75) | 12.3 | (0-75) | 7.3 | (0.2-59.3) | |
| Age (years) | Mean (SD) | 62.8 | ±18.1 | 63.3 | ±17.9 | 51.7 | ±20.1 | <0.0001 |
| Treatment | ||||||||
| VKAs | n (%) | 1135 | 52.2 | 1084 | 52 | 51 | 57.3 | 0.33 |
| LMWH | n (%) | 45 | 2.1 | 39 | 1.9 | 6 | 6.7 | 0.002 |
| DOACs | n (%) | 994 | 45.7 | 962 | 46.1 | 32 | 36 | 0.06 |
| Thrombophilia | n (%) | 279 | 12.8 | 267 | 12.8 | 12 | 13.5 | 0.85 |
| Previous VTE | n (%) | 503 | 23.1 | 487 | 23.4 | 16 | 18 | 0.24 |
[Baseline characteristics of non-cancer, non-CVC patients with UEDVT vs. LEDVT enrolled in the START2-Register]
[Clinical outcomes in non-cancer, non-CVC patients with UEDVT vs. LEDVT enrolled in the START2-Register]
To cite this abstract in AMA style:
Cohen O, Bertú L, Antonucci E, Palareti G, Ageno W. Clinical Characteristics and Outcomes of Non-cancer, Non-CVC Associated upper Extremity DVT [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/clinical-characteristics-and-outcomes-of-non-cancer-non-cvc-associated-upper-extremity-dvt/. Accessed January 23, 2022.« Back to ISTH 2020 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/clinical-characteristics-and-outcomes-of-non-cancer-non-cvc-associated-upper-extremity-dvt/