Abstract Number: PB2310
Meeting: ISTH 2020 Congress
Background: The risk of venous thromboembolism (VTE) is increased in pregnancy and postpartum such that VTE is a leading cause of maternal mortality.
Aims: Investigate the clinical characteristics, diagnostic strategies, treatment patterns and 12-month outcomes of women with pregnancy-associated VTE enrolled in the Global Anticoagulant Registry in the FIELD (GARFIELD)-VTE.
Methods: GARFIELD-VTE (ClinicalTrials.gov: NCT02155491) is a non-interventional study observing real-world treatment practices. Of the 10,870 patients with objectively confirmed VTE enrolled between May 2014 and January 2017, women of childbearing age (< 45 years) were stratified into those with (n=183) or without (n=1187) pregnancy-associated VTE.
Results: Women with pregnancy-associated VTE were younger (30.5 years vs. 34.8 years) and less likely to have had a pulmonary embolism (PE) than those without (19.7% vs. 32.3%). Deep vein thrombosis (DVT) in women with pregnancy-associated VTE occurred more frequently in the left leg (73.9%) than in women without pregnancy-associated VTE (54.8%). The most common VTE risk factors in pregnancy-associated VTE patients were hospitalisation (10.4%), previous surgery (10.4%), and family history of VTE (9.3%). Compression ultrasonography was used to diagnose DVT in 98.7% of pregnancy-associated VTE patients, whilst spiral/chest computed tomography scan was frequently used to diagnose PE (75.0%). 43.2% of pregnancy-associated VTE patients received parenteral therapy alone, 50.4% received a VKA or a DOAC (Figure 1). After adjustment for baseline characteristics, the risk of all-cause mortality (HR 0.59 [95% CI: 0.18-1.98]), recurrent VTE (HR 0.82 [95% CI 0.34-1.94]) and major bleeding
(HR 1.13 [95% CI 0.33-3.90]) were comparable between patients with or without pregnancy-associated VTE (Table 1).
Conclusions: Half of all patients with pregnancy-associated VTE received either a VKA or a DOAC, despite limited evidence for their use in this population. The rate of clinical outcomes was comparable between patient groups.
To cite this abstract in AMA style:Jerjes-Sanchez C, Rodriguez D, Farjat AE, Kayani G, MacCallum P, Lopes RD, Turpie AGG, Weitz JI, Haas S, Ageno W, Goto S, Goldhaber SZ, Angchaisuksiri P, Dalsgaard Nielsen J, Schellong S, Bounameaux H, Mantovani LG, Prandoni P, Kakkar AK, on Behalf of the GARFIELD-VTE Investigators . Pregnancy-Associated Venous Thromboembolism: Insights from GARFIELD-VTE [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/pregnancy-associated-venous-thromboembolism-insights-from-garfield-vte/. Accessed May 9, 2021.
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