Venous thromboembolism characteristics, treatment and outcomes in young adults: findings from the Registro Informatizado de Enfermedad TromboEmbólica registry

RIETE Investigators

doi:10.1016/j.jtha.2023.06.031

Venous thromboembolism characteristics, treatment and outcomes in young adults: findings from the Registro Informatizado de Enfermedad TromboEmbólica registry

RIETE Investigators

Bar-Ilan University - Azrieli Faculty of Medicine

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Venous thromboembolism (VTE) is rare in patients aged <21 years. Young adults aged 18 to 21 years are frequently included in adult VTE studies, whereas pediatric VTE studies include patients aged up to either 18 or 21 years. The clinical characteristics of young adult patients with VTE have not been well defined. Objectives: We aimed to highlight any unique characteristics or treatment considerations that may apply to young adult patients with VTE. Methods: Data from the prospective, international Registro Informatizado de Enfermedad TromboEmbólica registry were used. Patients were stratified into subcohorts according to age. The clinical characteristics, risk factors, management, and outcomes of young adult patients with VTE were compared with those of adolescents aged 12 to 18 years and adults aged >21 years. Results: Of 104 253 Registro Informatizado de Enfermedad TromboEmbólica patients enrolled until August 2022, 234 were adolescents and 884 were young adults. Less cases of pulmonary embolism were reported in adolescents (P < .001). Estrogen use was a common risk factor, more prevalent in adolescents and young adults (P < .001), whereas active cancer and immobilization were uncommon in both. Most patients were initially treated with low-molecular–weight heparin. VTE recurrence, major bleeding, and all-cause mortality rates were comparably low among adolescents and young adults. None of the patients aged <21 years died from VTE recurrence. Conclusion: Young adults have some distinctive VTE risk factors. While VTE presentation may be similar among young adults and older patients, the outcomes of patients aged <21 years are more favorable.

Original language	English
Pages (from-to)	2811-2823
Number of pages	13
Journal	Journal of Thrombosis and Haemostasis
Volume	21
Issue number	10
Early online date	3 Jul 2023
DOIs	https://doi.org/10.1016/j.jtha.2023.06.031
State	Published - Oct 2023

Bibliographical note

Publisher Copyright:
© 2023

Funding

We express our gratitude to Sanofi Spain and ROVI for supporting this Registry with an unrestricted educational grant. We also thank the RIETE Registry Coordinating Center, S&H Medical Science Service, for their quality control data, logistic and administrative support and Prof. Salvador Ortiz, Universidad Autónoma Madrid, Statistical Advisor in S&H Medical Science Service for the statistical analysis of the data presented in this paper. O.C. M.d.V.M. and G.K. performed study conception and design. All authors interpreted the data. O.C. and G.K. wrote the manuscript. All authors critically revised the manuscript and approved the final version of the article. There are no competing interests to disclose. RIETE is an investigator-initiated registry. It has been previously supported by Red Respira from the Instituto Carlos III, Spain (Red Respira-ISCiii-RTIC-03/11), by Sanofi Spain in Spain and by Bayer Pharma AG for the rest of the world. None of these sponsors have had any role in the design of the registry nor do they have rights to access the database, review or comment on prepublished studies from RIETE. Funding information Registro Informatizado de Enfermedad TromboEmbólica is an investigator-initiated registry previously supported by Red Respira from the Instituto Carlos III, Spain (Red Respira-ISCiii-RTIC-03/11), Sanofi, Spain, and Bayer Pharma AG worldwide. None of these sponsors have had any role in the design of the registry, nor do they have rights to access the database, review, or comment on prepublished studies from Registro Informatizado de Enfermedad TromboEmbólica. Funding information Registro Informatizado de Enfermedad TromboEmbólica is an investigator-initiated registry previously supported by Red Respira from the Instituto Carlos III, Spain (Red Respira-ISCiii-RTIC-03/11), Sanofi, Spain, and Bayer Pharma AG worldwide. None of these sponsors have had any role in the design of the registry, nor do they have rights to access the database, review, or comment on prepublished studies from Registro Informatizado de Enfermedad TromboEmbólica.

Funders	Funder number
RIETE
Registro Informatizado de Enfermedad TromboEmbólica
S&H Medical Science Service
Bayer
Sanofi
Instituto de Salud Carlos III	Respira-ISCiii-RTIC-03/11
Universidad Autónoma de Madrid

Keywords

adolescents
anticoagulants
venous thromboembolism
young adults

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.jtha.2023.06.031

Cite this

@article{2d2713deb4da45f4aac539380b5df52f,

title = "Venous thromboembolism characteristics, treatment and outcomes in young adults: findings from the Registro Informatizado de Enfermedad TromboEmb{\'o}lica registry",

abstract = "Background: Venous thromboembolism (VTE) is rare in patients aged <21 years. Young adults aged 18 to 21 years are frequently included in adult VTE studies, whereas pediatric VTE studies include patients aged up to either 18 or 21 years. The clinical characteristics of young adult patients with VTE have not been well defined. Objectives: We aimed to highlight any unique characteristics or treatment considerations that may apply to young adult patients with VTE. Methods: Data from the prospective, international Registro Informatizado de Enfermedad TromboEmb{\'o}lica registry were used. Patients were stratified into subcohorts according to age. The clinical characteristics, risk factors, management, and outcomes of young adult patients with VTE were compared with those of adolescents aged 12 to 18 years and adults aged >21 years. Results: Of 104 253 Registro Informatizado de Enfermedad TromboEmb{\'o}lica patients enrolled until August 2022, 234 were adolescents and 884 were young adults. Less cases of pulmonary embolism were reported in adolescents (P < .001). Estrogen use was a common risk factor, more prevalent in adolescents and young adults (P < .001), whereas active cancer and immobilization were uncommon in both. Most patients were initially treated with low-molecular–weight heparin. VTE recurrence, major bleeding, and all-cause mortality rates were comparably low among adolescents and young adults. None of the patients aged <21 years died from VTE recurrence. Conclusion: Young adults have some distinctive VTE risk factors. While VTE presentation may be similar among young adults and older patients, the outcomes of patients aged <21 years are more favorable.",

keywords = "adolescents, anticoagulants, venous thromboembolism, young adults",

author = "{RIETE Investigators} and Omri Cohen and Barg, {Assaf A.} and Ulrike Nowak-G{\"o}ttl and Cristina Amado-Fern{\'a}ndez and Lucia Mazzolai and Gregorio Tiberio and Sebastian Schellong and Andris Skride and Morales, {Mar{\'i}a del Valle} and Manuel Monreal and Gili Kenet and Paolo Prandoni and Benjamin Brenner and Dominique Farge-Bancel and Raquel Barba and {Di Micco}, Pierpaolo and Laurent Bertoletti and Inna Tzoran and Abilio Reis and Marijan Bosevski and Henri Bounameaux and Radovan Mal{\'y} and Peter Verhamme and Caprini, {Joseph A.} and Bui, {Hanh My} and Adarraga, {M. D.} and A. Alberich-Conesa and J. Alonso-Carrillo and C. Amado and S. Amor{\'o}s and Arcelus, {J. I.} and A. Ballaz and R. Barba and C. Barbagelata and M. Barr{\'o}n and B. Barr{\'o}n-Andr{\'e}s and A. Blanco-Molina and E. Botella and I. Casado and L. Chasco and P. Cerd{\`a} and J. Criado and {del Toro}, J. and {De Juana-Izquierdo}, C. and P. Demelo-Rodr{\'i}guez and D{\'i}az-Brasero, {A. M.} and D{\'i}az-Pedroche, {M. C.} and D{\'i}az-Peromingo, {J. A.} and A. Dubois-Silva and A. Braester",

note = "Publisher Copyright: {\textcopyright} 2023",

year = "2023",

month = oct,

doi = "10.1016/j.jtha.2023.06.031",

language = "אנגלית",

volume = "21",

pages = "2811--2823",

journal = "Journal of Thrombosis and Haemostasis",

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TY - JOUR

T1 - Venous thromboembolism characteristics, treatment and outcomes in young adults

T2 - findings from the Registro Informatizado de Enfermedad TromboEmbólica registry

AU - RIETE Investigators

AU - Cohen, Omri

AU - Barg, Assaf A.

AU - Nowak-Göttl, Ulrike

AU - Amado-Fernández, Cristina

AU - Mazzolai, Lucia

AU - Tiberio, Gregorio

AU - Schellong, Sebastian

AU - Skride, Andris

AU - Morales, María del Valle

AU - Monreal, Manuel

AU - Kenet, Gili

AU - Prandoni, Paolo

AU - Brenner, Benjamin

AU - Farge-Bancel, Dominique

AU - Barba, Raquel

AU - Di Micco, Pierpaolo

AU - Bertoletti, Laurent

AU - Tzoran, Inna

AU - Reis, Abilio

AU - Bosevski, Marijan

AU - Bounameaux, Henri

AU - Malý, Radovan

AU - Verhamme, Peter

AU - Caprini, Joseph A.

AU - Bui, Hanh My

AU - Adarraga, M. D.

AU - Alberich-Conesa, A.

AU - Alonso-Carrillo, J.

AU - Amado, C.

AU - Amorós, S.

AU - Arcelus, J. I.

AU - Ballaz, A.

AU - Barba, R.

AU - Barbagelata, C.

AU - Barrón, M.

AU - Barrón-Andrés, B.

AU - Blanco-Molina, A.

AU - Botella, E.

AU - Casado, I.

AU - Chasco, L.

AU - Cerdà, P.

AU - Criado, J.

AU - del Toro, J.

AU - De Juana-Izquierdo, C.

AU - Demelo-Rodríguez, P.

AU - Díaz-Brasero, A. M.

AU - Díaz-Pedroche, M. C.

AU - Díaz-Peromingo, J. A.

AU - Dubois-Silva, A.

AU - Braester, A.

PY - 2023/10

Y1 - 2023/10

N2 - Background: Venous thromboembolism (VTE) is rare in patients aged <21 years. Young adults aged 18 to 21 years are frequently included in adult VTE studies, whereas pediatric VTE studies include patients aged up to either 18 or 21 years. The clinical characteristics of young adult patients with VTE have not been well defined. Objectives: We aimed to highlight any unique characteristics or treatment considerations that may apply to young adult patients with VTE. Methods: Data from the prospective, international Registro Informatizado de Enfermedad TromboEmbólica registry were used. Patients were stratified into subcohorts according to age. The clinical characteristics, risk factors, management, and outcomes of young adult patients with VTE were compared with those of adolescents aged 12 to 18 years and adults aged >21 years. Results: Of 104 253 Registro Informatizado de Enfermedad TromboEmbólica patients enrolled until August 2022, 234 were adolescents and 884 were young adults. Less cases of pulmonary embolism were reported in adolescents (P < .001). Estrogen use was a common risk factor, more prevalent in adolescents and young adults (P < .001), whereas active cancer and immobilization were uncommon in both. Most patients were initially treated with low-molecular–weight heparin. VTE recurrence, major bleeding, and all-cause mortality rates were comparably low among adolescents and young adults. None of the patients aged <21 years died from VTE recurrence. Conclusion: Young adults have some distinctive VTE risk factors. While VTE presentation may be similar among young adults and older patients, the outcomes of patients aged <21 years are more favorable.

AB - Background: Venous thromboembolism (VTE) is rare in patients aged <21 years. Young adults aged 18 to 21 years are frequently included in adult VTE studies, whereas pediatric VTE studies include patients aged up to either 18 or 21 years. The clinical characteristics of young adult patients with VTE have not been well defined. Objectives: We aimed to highlight any unique characteristics or treatment considerations that may apply to young adult patients with VTE. Methods: Data from the prospective, international Registro Informatizado de Enfermedad TromboEmbólica registry were used. Patients were stratified into subcohorts according to age. The clinical characteristics, risk factors, management, and outcomes of young adult patients with VTE were compared with those of adolescents aged 12 to 18 years and adults aged >21 years. Results: Of 104 253 Registro Informatizado de Enfermedad TromboEmbólica patients enrolled until August 2022, 234 were adolescents and 884 were young adults. Less cases of pulmonary embolism were reported in adolescents (P < .001). Estrogen use was a common risk factor, more prevalent in adolescents and young adults (P < .001), whereas active cancer and immobilization were uncommon in both. Most patients were initially treated with low-molecular–weight heparin. VTE recurrence, major bleeding, and all-cause mortality rates were comparably low among adolescents and young adults. None of the patients aged <21 years died from VTE recurrence. Conclusion: Young adults have some distinctive VTE risk factors. While VTE presentation may be similar among young adults and older patients, the outcomes of patients aged <21 years are more favorable.

KW - adolescents

KW - anticoagulants

KW - venous thromboembolism

KW - young adults

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DO - 10.1016/j.jtha.2023.06.031

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AN - SCOPUS:85167782188

SN - 1538-7933

VL - 21

SP - 2811

EP - 2823

JO - Journal of Thrombosis and Haemostasis

JF - Journal of Thrombosis and Haemostasis

IS - 10

ER -

Venous thromboembolism characteristics, treatment and outcomes in young adults: findings from the Registro Informatizado de Enfermedad TromboEmbólica registry

Abstract

Bibliographical note

Funding

Keywords

UN SDGs

Access to Document

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