タカダ　タクマ   Takada Takuma   髙田　卓磨    所属   研究施設 研究施設    職種   非常勤講師
言語種別	英語
発表タイトル	Clinical Characteristics, Anticoagulation Strategies and Outcomes Comparing Patients with and without History of Venous Thromboembolism: From the COMMAND VTE Registry-2
会議名	第87回日本循環器学会学術集会
学会区分	全国規模の学会
発表形式	口頭
講演区分	一般
発表者・共同発表者	Kosuke Doi, Ryuki Chatani, Kazuhisa Kaneda, Yuji Nishimoto, Nobutaka Ikeda, Yohei Kobayashi, Satoshi Ikeda, Kite Kim, Toru Takase, Shuhei Tsuji, Maki Ohi, Takuma Takada, Kazunori Otsui, Jiro Sakamoto, Yoshito Ogihara, Masaharu Akao, Yugo Yamashita
発表年月日	2023/03/10
開催地 （都市, 国名）	福岡
概要	Background: Patients with history of venous thromboembolism (VTE) were reported to be at a higher risk of recurrence than those without. However, there has been limited data on the issue in the Era of direct oral anticoagulant (DOAC) for VTE. Method: The COMMAND VTE Registry-2 is a multicenter registry enrolling 5,197 consecutive acute symptomatic VTE patients among 31 centers in Japan between January 2015 and August 2020. We divided the entire cohort into patients with history of VTE (N=362) and those without (N=4,835). Result: Patients with history of VTE were younger (65.4 vs. 67.9 years, P<0.01), and less often had active cancer at diagnosis (23% vs. 30%, P=0.01). Unprovoked VTE was more frequent in patients with history of VTE (50% vs. 36%), while provoked VTE by a transient risk factor was less frequent in them (14% vs. 25%). The cumulative discontinuation rate of anticoagulation therapy was lower in patients with history of VTE (36.2% vs. 60.7% at 5-year). There was no significant difference in the cumulative incidence of recurrent VTE between the groups (11.7% vs. 9.4%, P=0.09). There were also no significant differences in the cumulative incidences of major bleeding nor all-cause death between the groups (major bleeding: 11.8% vs. 13.9%, P=0.46; all-cause death: 27.6% vs. 32.6%, P=0.09). After adjusting confounders, the risk of patients with history of VTE relative to those without for recurrent VTE remained insignificant (HR, 1.30, 95%CI, 0.86-1.89, P=0.21). Conclusion: Patients with history of VTE received a longer duration of anticoagulation therapy, but did not show a higher risk of recurrent VTE than those without.