Abstract Number: PB2311
Meeting: ISTH 2020 Congress
Background: There is limited information on the influence of obesity on outcomes in venous thromboembolism (VTE) patients.
Aims: Investigate the influence of body mass index (BMI) on baseline characteristics, treatment patterns and 2-year outcomes in VTE patients.
Methods: GARFIELD-VTE is a prospective, non-interventional registry of 10,870 patients with objectively confirmed VTE, enrolled between May 2014 and January 2017. Patients were grouped according to BMI as follows: < 18.5 (underweight; n=215); 18.5-24.9 (normal; n=2865); 25.0-29.9 (overweight; n=3332); ≥ 30 (obese; n=3076).
Results: The mean age and distribution of VTE events were comparable across groups. Compared with patients with a normal BMI, obese patients were more frequently Caucasian (77.3% vs. 57.9%), treated in the outpatient setting (30.4% vs. 23.2%); less likely to have active cancer (5.9% vs. 11.6%) but more likely to have had a previous VTE (17.6% vs. 11.6%). At baseline, obese patients were less likely than those with a normal BMI to receive parenteral therapy alone (14.6% vs. 21.8%), and a greater proportion of obese patients remained on anticoagulation treatment over 2 years (48.5% vs. 37.6%) (Figure 1). After 24 months of follow-up, the risk of all-cause mortality was lower in obese patients than in those with normal BMI (adjusted hazard ratio: 0.66; 95% confidence interval: 0.55-0.79). The risks of recurrent VTE and major bleeding were comparable (Table 1). Among obese patients, the unadjusted rate of all-cause mortality was higher in those receiving parenteral therapy (12.30 per 100 person-years) than in those receiving a DOAC (1.66 per 100 person-years) or VKAs (2.88 per 100 person-years). Patients with a BMI≥40 had an increased risk of any bleeding compared with those with BMI of 35-39.9 or 30-34.9 (11.01, 8.56 and 6.56 per 100 person-years, respectively).
Conclusions: Obese VTE patients have a reduced risk of mortality compared with patients with normal BMI, even after adjustment for baseline characteristics.
[Figure 1. Anticoagulation treatment patterns over 24 months’ follow-up.]
To cite this abstract in AMA style:Weitz JI, Ageno W, Farjat AE, Turpie AGG, Haas S, Goto S, Goldhaber SZ, Angchaisuksiri P, Gibbs H, MacCallum P, Carrier M, Dalsgaard Nielsen J, Kayani G, Schellong S, Bounameaux H, Mantovani LG, Prandoni P, Kakkar AK, on Behalf of the GARFIELD-VTE Investigators . Influence of Body Mass Index on Outcomes in Patients with Venous Thromboembolism: Insights from GARFIELD-VTE [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/influence-of-body-mass-index-on-outcomes-in-patients-with-venous-thromboembolism-insights-from-garfield-vte/. Accessed October 21, 2021.
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