Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University.
Department of Clinical Epidemiology, Hyogo College of Medicine.
Circ J. 2019 Jun 25;83(7):1581-1589. doi: 10.1253/circj.CJ-19-0229. Epub 2019 May 28.
It remains controversial whether sex category is a risk for recurrent venous thromboembolism (VTE) and major bleeding among VTE patients.
The COMMAND VTE Registry is a multicenter registry enrolling 3,027 consecutive acute symptomatic VTE patients from 29 centers in Japan between January 2010 and August 2014. We compared the clinical characteristics and outcomes of men and women. Men accounted for 1,169 (39%) and women 1,858 (61%). Compared with women, men were younger (64.9±14.7 vs. 68.6±15.6 years old, P<0.001), more often had prior VTE (7.2% vs. 5.1%, P=0.02), and less often had transient risk factors for VTE (30% vs. 40%, P<0.001). The proportions of active cancer and pulmonary embolism were comparable between men and women (24% vs. 22%, P=0.26; 56% vs. 57%, P=0.48, respectively). The cumulative 3-year incidences of recurrent VTE, major bleeding, and all-cause death were not significantly different between men and women (7.0% vs. 8.6%, P=0.47; 10.6% vs. 9.2%, P=0.25; 25.2% vs. 23.4%, P=0.35, respectively). The adjusted risks of men relative to women for recurrent VTE and for major bleeding remained insignificant (HR 0.83, 95% CI 0.63-1.09, P=0.17; HR 1.15, 95% CI 0.90-1.47, P=0.25, respectively).
In real-world VTE patients, the clinical characteristics differed between men and women, but there was not a large sex-related difference in the risks for recurrent VTE or major bleeding.
性别是否是静脉血栓栓塞症(VTE)患者复发性静脉血栓栓塞症(VTE)和大出血的危险因素仍存在争议。
COMMAND VTE 登记处是一项多中心登记处,于 2010 年 1 月至 2014 年 8 月期间在日本 29 个中心共纳入了 3027 例急性有症状的 VTE 患者。我们比较了男性和女性的临床特征和结局。男性占 1169 例(39%),女性占 1858 例(61%)。与女性相比,男性更年轻(64.9±14.7 岁 vs. 68.6±15.6 岁,P<0.001),更常患有既往 VTE(7.2% vs. 5.1%,P=0.02),且更少见 VTE 的一过性危险因素(30% vs. 40%,P<0.001)。男性和女性的活动性癌症和肺栓塞的比例相当(24% vs. 22%,P=0.26;56% vs. 57%,P=0.48)。男性和女性的 3 年累积复发性 VTE、大出血和全因死亡率无显著差异(7.0% vs. 8.6%,P=0.47;10.6% vs. 9.2%,P=0.25;25.2% vs. 23.4%,P=0.35)。校正后,男性与女性相比,复发性 VTE 和大出血的风险无显著差异(HR 0.83,95%CI 0.63-1.09,P=0.17;HR 1.15,95%CI 0.90-1.47,P=0.25)。
在真实世界的 VTE 患者中,男性和女性的临床特征存在差异,但复发性 VTE 或大出血的风险无明显的性别差异。