Abstract Number: PB2400
Meeting: ISTH 2020 Congress
Theme: Venous Thromboembolism and Cardioembolism » VTE Treatment
Background: Patients younger than 40 years with acute venous thromboembolism (VTE) are thought to have different demographic characteristics and profile of risk factors compared to patients 40 to 75 years of age, which could be associated with different clinical outcomes.
Aims: Assess demographic profile, risk factors, and clinical outcomes such as VTE recurrence, major bleeding, clinically relevant non major bleeding (CRNMB) and survival in young patients treated with any anticoagulation (AC) for acute VTE and those treated only with direct oral anticoagulants (DOACs).
Methods: Consecutive patients enrolled in the Mayo Clinic VTE Registry between March 1, 2013 and November 30, 2019 for acute VTE were followed prospectively. Patient outcomes were assessed in person, by mailed questionnaire, or by a scripted phone interview.
Results: During the study period, there were 257 patients with age < 40 years and 2123 aged 40-75 years. Patients younger than 40 years were more often women with VTE provoked by trauma, hormonal therapy or pregnancy, or by other provoking factors, but far less often with underlying malignancy compared to patients with the age of 40-75 years (Table 1). Patients < 40 years old had lower mortality but bleeding clinical outcomes were not different than the reference age group (Table 2). VTE recurrence was also similar (2.43 versus 4.77 per 100 person-years, p=0.16). When comparing study groups for those patients treated with DOACs (n= 1392), clinical outcomes were still not statistically different with the exception of mortality.
Conclusions: Patients younger than 40 with acute VTE have a different demographic profile and set of risk factors but similar clinical outcomes compared to the reference age range. This does not change when patients are treated with DOACs. As expected, the age group < 40 had better survival compared to the group of patients between 40 and 75 years of age.
| Variable | Age <40 (n=257) | Age 40-75 (n=2123) | p-value | Age <40, DOACs (n=168) | Age 40-75, DOACs (n=1224) | p-value |
| Female, n (%) | 150 (58.4) | 915 (43.1) | <0.001 | 93 (55.4) | 540 (44.1) | 0.006 |
| PE, n (%) | 99 (38.5) | 934 (44.0) | 0.095 | 57 (33.9) | 508 (41.5) | 0.061 |
| DVT and PE, n (%) | 36 (14.0) | 455 (21.4) | 0.006 | 22 (13.1) | 234 (19.1) | 0.059 |
| Provoked VTE, n (%) | 207 (80.9) | 1734 (81.8) | 0.762 | 128 (76.6) | 943 (77.1) | 0.800 |
| Active cancer, n (%) | 49 (19.1) | 1024 (48.2) | <0.001 | 24 (14.3) | 474 (38.6) | <0.001 |
| Trauma, n (%) | 25(9.7) | 118 (5.6) | 0.008 | 22 (13.1) | 81 (6.6) | 0.003 |
| Hormonal therapy/pregnancy, n (%) | 61 (23.7) | 50 (2.4) | <0.001 | 35 (20.8) | 38 (3.1) | <0.001 |
| Other provoking factors, n (%) | 72 (28.0) | 439 (20.7) | 0.007 | 39 (23.2) | 256 (20.9) | 0.494 |
| Patients receiving DOACs, n (%) | 197 (76.7) | 1554 (73.2) | 0.235 | —- | —- |
[Table 1. Demographics and risk factors.]
| Outcome | Age <40 years | Age 40-75 years | p-value | Age <40, DOACs | Age 40-75, DOACs | p-value |
| Mortality | 12.02 | 30.37 | <0.001 | 10.64 | 23.89 | 0.008 |
| VTE recurrence | 2.43 | 4.77 | 0.16 | 2.94 | 3.52 | 0.70 |
| Major bleeding | 3.04 | 4.92 | 0.24 | 2.94 | 3.05 | 0.90 |
| CRNMB | 4.28 | 7.00 | 0.16 | 4.97 | 8.32 | 0.21 |
[Table 2. Clinical outcomes during the total treatment period (rates per 100 person-years).]
To cite this abstract in AMA style:
Vlazny DT, Wysokinski W, Houghton DE, Hodge DO, Froehling DA, Peterson LG, Casanegra AI. Demographics and Clinical Outcomes of Patients Younger than 40 Years Treated for Acute Venous Thromboembolism [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/demographics-and-clinical-outcomes-of-patients-younger-than-40-years-treated-for-acute-venous-thromboembolism/. Accessed September 29, 2023.« Back to ISTH 2020 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/demographics-and-clinical-outcomes-of-patients-younger-than-40-years-treated-for-acute-venous-thromboembolism/