TAKADA Takuma    Department   Research Institutes and Facilities, Research Institutes and Facilities    Position   Assistant Professor
Language	English
Title	Actual Management of Venous Thromboembolism Complicated by Antiphospholipid Antibody Syndrome in Japan. From the COMMAND VTE Registry-2
Conference	第87回日本循環器学会学術集会
Conference Type	Nationwide Conferences
Presentation Type	Speech
Lecture Type	General
Publisher and common publisher	Takahiro Kuno, Norimichi Koitabashi, Yoshiaki Ohyama, Noriaki Takama, Masaru Obokata, Ryuki Chatani, Kazuhisa Kaneda, Yuji Nishimoto, Nobutaka Ikeda, Yohei Kobayashi, Satoshi Ikeda, Kitae Kim, Toru Takase, Shuhei Tsuji, Maki Ohi, Takuma Takada, Kazunori Otsui, Jiro Sakamoto, Yugo Yamashita, Hideki Ishii
Date	2023/03/10
Venue (city and name of the country)	福岡
Summary	Background Venous thromboembolism (VTE) complicated with antiphospholipid antibody syndrome (APS) requires long-term anticoagulation to prevent the recurrent thrombosis. Direct oral anticoagulants (DOACs) have been widely used for VTE, but the guideline recommendations for their use are less favorable for APS-complicated VTE. There are no reports on the actual practice of APS complicated VTE in Japan in the DOAC era. Methods 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. In this cohort, we examined the differences in actual VTE practice between patients with and without APS. Results The current study population consisted of 83 APS-complicated VTE (mean age, 55; 53 male patients [63.9%]), and 5,114 VTE patients without APS (mean age, 68; 3010 male patients [58.9%]). Compared with patients without (w/o) APS, those with (w/) APS were more likely to have proximal deep vein thrombosis (DVT) than distal DVT, but the rate of pulmonary embolism was comparable. There was no difference in the rate DOAC use between patients w/[74.7%] and w/oAPS [79.5%]. All-cause mortality was significantly lower in the APS group (w/APS 6 [7.2%]; w/oAPS 1317 [25.8%]), VTE recurrence rates were similar (w/APS 8 [9.6%]; w/oAPS 275 [5.4%]), and the interval to VTE recurrence was significantly longer in the APS group (median: w/APS, 1050 days; w/oAPS 724 days). Major bleeding event rate was comparable (w/APS 8 [9.6%]; w/oAPS 462 [9.0%]). Conclusion DOACs were used equally in long-term anticoagulation of VTE complicated with APS compared with VTE without APS, with better outcome.