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亚洲和全球静脉血栓栓塞症:来自 GARFIELD-VTE 的新见解。

Venous thromboembolism in Asia and worldwide: Emerging insights from GARFIELD-VTE.

机构信息

Division of Hematology, Department of Medicine, Ramathibodi Hospital, Mahidol University, Thailand.

Department of Medicine (Cardiology), Tokai University School of Medicine, Japan.

出版信息

Thromb Res. 2021 May;201:63-72. doi: 10.1016/j.thromres.2021.02.024. Epub 2021 Feb 24.

Abstract

BACKGROUND

Although epidemiological studies report a lower risk of venous thromboembolism (VTE) than in the Western world, VTE rates in Asia may be underestimated. Furthermore, it is uncertain whether VTE outcomes differ in Asia and the rest of the world (ROW).

METHODS

GARFIELD-VTE is a global, prospective, non-interventional study of real-world treatment practices. In this study, we compared baseline characteristics, treatment patterns, and 12-month outcomes in Asia and ROW.

RESULTS

Of the 10,684 enrolled patients, 1822 (17.1%) were Asian (China n = 420, Hong Kong n = 98, Japan n = 148, Malaysia n = 244, South Korea n = 343, Taiwan n = 232, Thailand n = 337). Compared with ROW patients, those from Asia were more often female (57.4% vs. 48.0%), non-smokers (74.0% vs. 58.9%) and had a lower BMI (24.8 kg/m vs. 29.1 kg/m). Asian patients were more likely to be managed in the hospital (86.9% vs. 70.4%) and to have active cancer (19.8% vs. 8.1%) or a history of cancer (19.1% vs. 12.0%). Asian patients received no anticoagulation more frequently than ROW patients (6.5% vs. 2.1%). Over 12-months follow-up, the rate of all-cause mortality (per 100 person-years [95% confidence interval]) was higher in Asians (15.2 [13.4-17.3] vs. 5.9 [5.4-6.5]). Adjusted hazard ratios indicated a higher risk of all-cause mortality in Asian patients than the ROW (1.32 [1.08-1.62]). The frequencies of major bleeding and recurrent VTE were similar.

CONCLUSION

Asian patients have different risk profiles, treatment patterns and a higher risk of mortality compared with the ROW.

摘要

背景

尽管流行病学研究报告亚洲静脉血栓栓塞症(VTE)的风险低于西方世界,但亚洲的 VTE 发生率可能被低估。此外,亚洲与世界其他地区(ROW)的 VTE 结局是否不同尚不确定。

方法

GARFIELD-VTE 是一项全球性、前瞻性、非干预性的真实世界治疗实践研究。在这项研究中,我们比较了亚洲和 ROW 的基线特征、治疗模式和 12 个月的结局。

结果

在纳入的 10684 名患者中,有 1822 名(17.1%)为亚洲人(中国 n=420,中国香港 n=98,日本 n=148,马来西亚 n=244,韩国 n=343,中国台湾 n=232,泰国 n=337)。与 ROW 患者相比,亚洲患者更多为女性(57.4% vs. 48.0%)、不吸烟者(74.0% vs. 58.9%)且 BMI 较低(24.8 kg/m vs. 29.1 kg/m)。亚洲患者更可能在医院接受治疗(86.9% vs. 70.4%),且更可能患有活动性癌症(19.8% vs. 8.1%)或有癌症病史(19.1% vs. 12.0%)。亚洲患者未接受抗凝治疗的比例高于 ROW 患者(6.5% vs. 2.1%)。在 12 个月的随访期间,亚洲人的全因死亡率(每 100 人年[95%置信区间])高于 ROW(15.2 [13.4-17.3] vs. 5.9 [5.4-6.5])。调整后的风险比表明,亚洲患者的全因死亡风险高于 ROW(1.32 [1.08-1.62])。大出血和复发性 VTE 的频率相似。

结论

与 ROW 相比,亚洲患者具有不同的风险特征、治疗模式和更高的死亡率。

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