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一项为期6个月的多中心观察性研究,旨在调查希腊静脉血栓栓塞症的治疗情况(维多利亚研究)。

Α 6-month, multicenter, observational study investigating the treatment of venous thromboembolism in Greece (VICTORIA study).

作者信息

Savvari Paraskevi, Skiadas Ioannis, Mavrokefalou Evgenia, Kakkos Stavros, Antoniou Ioulia, Pitoulias Georgios A, Dima Effrosyni, Ferdoutsis Emmanouil, Ntaios Georgios, Giannoukas Athanasios, Kotsiou Ourania, Zagouri Flora, Tsoukalas Georgios, Kostikas Konstantinos, Staramos Dimitrios, Milionis Haralampos, Filis Konstantinos, Savopoulos Christos, Kakisis Ioannis, Tzilalis Vasileios, Koulouris Nikolaos, Papas Theophanis, Skrapari Ioanna, Menegas Damianos

机构信息

Medical Affairs, Pfizer Hellas S.A, 243 Messoghion Ave, Athens, N. Psychiko, 154 51, Greece.

4th Department of Internal Medicine, Evangelismos Hospital, Athens, Greece.

出版信息

Thromb J. 2025 Jun 23;23(1):71. doi: 10.1186/s12959-025-00749-1.

Abstract

BACKGROUND

Real-world data are needed to inform clinical practice with regards to anticoagulation treatment for persons with venous thromboembolism (VTE).

OBJECTIVES

To identify the type and duration of antithrombotic treatment in persons with VTE. Anticoagulation dosage and persistence/adherence were among the secondary objectives.

METHODS

A multicenter, observational, prospective study conducted in Greek adults with VTE with two on-site visits -baseline and at three months- and a telephone follow-up at 6 months.

RESULTS

A total of 600 eligible persons were enrolled. The index event was 'PE only' in 50%, 'DVT only' in 40%, and 'DVT+PE' in 10%. Risk factors were categorized as temporary major (21%), temporary minor (37%), and persistent (43%), with active cancer present in 18% of patients. All VTE patients received anticoagulants: 73% received oral anticoagulants (72% DOACs, 1% VKAs) and 70% received parenteral anticoagulants. Treatment was oral only in 30%, parenteral only in 27%, and both in 43%. The most common DOAC was apixaban (47%). Extended anticoagulation (>6 months) was administered to 41% with only 9% (18/198) of those on DOACs receiving a reduced dose. Persistent risk factors predicted extended anticoagulation, while diabetes, COVID-19, and temporary minor risk factors did not. Adherence/persistence rates were similar between DOAC and non-DOAC-treated patients.

CONCLUSION

VTE was mainly treated with a combination of parenteral and oral anticoagulants. DOACs, primarily apixaban, were the most common oral treatments. Forty percent of patients received extended anticoagulation, mostly at standard dosages. Adherence and persistence rates were high for both DOAC and non-DOAC treatments.

摘要

背景

需要真实世界的数据来指导静脉血栓栓塞症(VTE)患者的抗凝治疗临床实践。

目的

确定VTE患者的抗栓治疗类型和持续时间。抗凝剂量以及持续性/依从性是次要目标。

方法

在希腊成年VTE患者中进行了一项多中心、观察性、前瞻性研究,进行两次现场访视——基线访视和三个月时的访视——以及六个月时的电话随访。

结果

共纳入600名符合条件的患者。索引事件为“仅肺栓塞(PE)”的占50%,“仅深静脉血栓形成(DVT)”的占40%,“DVT + PE”的占10%。危险因素分为临时主要因素(21%)、临时次要因素(37%)和持续性因素(43%),18%的患者存在活动性癌症。所有VTE患者均接受抗凝治疗:73%接受口服抗凝药(72%为直接口服抗凝剂[DOACs],1%为维生素K拮抗剂[VKAs]),70%接受肠外抗凝剂。仅口服治疗的占30%,仅肠外治疗的占27%,两者皆有的占43%。最常用的DOAC是阿哌沙班(47%)。41%的患者接受了延长抗凝治疗(>6个月),接受DOAC治疗的患者中只有9%(18/198)接受了减量。持续性危险因素预示着延长抗凝治疗,而糖尿病、2019冠状病毒病(COVID - 19)和临时次要危险因素则不然。DOAC治疗组和非DOAC治疗组的依从性/持续性率相似。

结论

VTE主要采用肠外和口服抗凝剂联合治疗。DOACs,主要是阿哌沙班,是最常见的口服治疗药物。40%的患者接受了延长抗凝治疗,大多采用标准剂量。DOAC治疗组和非DOAC治疗组的依从性和持续性率都很高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51bc/12183886/06bad2e71e20/12959_2025_749_Fig1_HTML.jpg

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