Department of Cardiology, Mitsubishi Kyoto Hospital, Kyoto, Japan.
Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Thromb Res. 2021 Feb;198:26-33. doi: 10.1016/j.thromres.2020.11.022. Epub 2020 Nov 25.
There is a paucity of data on the influence of low body weight on clinical outcomes in patients with acute venous thromboembolism (VTE).
The COMMAND VTE registry is a multicenter cohort study enrolling 3027 consecutive patients with acute symptomatic VTE. The current study population consisted of 2778 patients with available body weight value, who were divided into 2 groups; 1705 patients with lower body weight (≤60 kg) and 1073 patients with higher body weight (>60 kg).
Patients with lower body weight were older (70.8 versus 60.9 years, P < 0.001), and more often women (75% versus 38%, P < 0.001), and more often had active cancer (27% versus 19%, P < 0.001) than those with higher body weight. The cumulative 5-year incidence of recurrent VTE was not significantly different between the 2 groups (10.6% versus 10.7%, P = 0.51). The cumulative 5-year incidences of major bleeding and all-cause death were significantly higher in patients with lower body weight than in those with higher body weight (14.6% versus 9.6%, P < 0.001, and 35.8% versus 19.8%, P < 0.001, respectively). The excess adjusted risk of patients with lower body weight relative to those with higher body weight remained significant for major bleeding and all-cause death (HR 1.57, 95%CI: 1.16-2.12, P = 0.003, and HR 1.50, 95%CI: 1.24-1.81, P < 0.001, respectively).
In the current Japanese real-world registry, there were a high proportion of patients with low body weight, who had a higher risk for major bleeding and mortality without significant excess risk for recurrent VTE.
关于低体重对急性静脉血栓栓塞症（VTE）患者临床结局的影响，相关数据十分匮乏。
COMMAND VTE 注册研究是一项多中心队列研究，共纳入 3027 例急性有症状 VTE 患者。本研究的当前人群由 2778 例可获得体重值的患者组成，他们被分为两组：体重较低（≤60kg）的 1705 例患者和体重较高（>60kg）的 1073 例患者。
与体重较高的患者相比，体重较低的患者年龄更大（70.8 岁比 60.9 岁，P<0.001），女性更多（75%比 38%，P<0.001），且更常患有活动性癌症（27%比 19%，P<0.001）。两组患者的 5 年累积复发性 VTE 发生率无显著差异（10.6%比 10.7%，P=0.51）。体重较低的患者 5 年累积大出血发生率和全因死亡率显著高于体重较高的患者（14.6%比 9.6%，P<0.001，和 35.8%比 19.8%，P<0.001）。与体重较高的患者相比，体重较低的患者大出血和全因死亡的调整后风险比显著更高（HR 1.57，95%CI：1.16-2.12，P=0.003，和 HR 1.50，95%CI：1.24-1.81，P<0.001）。
在目前的日本真实世界登记研究中，低体重患者比例较高，他们大出血和死亡率的风险更高，而复发 VTE 的风险无显著增加。
