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American Heart Association

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Final ID: MDP138

Predictors of venous thromboembolism in hospitalized patients with COVID-19

Abstract Body (Do not enter title and authors here):
Background:
COVID-19 is a multiorgan disease characterized by a prothrombotic state and increased risk of venous thromboembolism (VTE), especially in hospitalized patients. Although prior studies have attempted to identify predictors of VTE, restricted sample size and use of administrative claims data have limited such analyses. We conducted a multivariable analysis to identify predictors of VTE in hospitalized patients with COVID-19 in a multicenter patient-level registry.

Methods:
We utilized data from the CORONA-VTE Network, a US multicenter registry of 10,420 adult (≥18 years) patients with PCR-confirmed COVID-19 of whom 3,844 were hospitalized. The primary outcome was time-to-first-event for a composite of adjudicated pulmonary embolism and deep vein thrombosis (e.g. lower extremity, mesenteric, gonadal vein, etc.) during 90-day follow-up. The candidate variables were selected by a priori clinical consensus. The variables with ≥20% missing data were excluded, whereas those with missing data <20% were estimated using multiple imputation. Selected variables included prophylactic anticoagulation during hospitalization, corticosteroid therapy, female sex, baseline prescriptions of anticoagulants and statins, use of hormone replacement therapy, history of peripheral artery disease, prior VTE, and known thrombophilia. Subsequently, we conducted cox proportional hazard regression adjusted for the selected variables for each imputed dataset and pooled the estimated HRs for reporting (p<0.05 for significance).

Results:
The overall rate of VTE was 5.39%. The covariates associated with increased risk of VTE were history of VTE (HR: 1.71; 95% CI: 1.11-2.63), corticosteroid therapy (HR: 1.76; 95% CI: 1.32-2.33) and known thrombophilia (HR: 3.56; 95% CI: 1.54-8.21). The covariates associated with decreased risk of VTE were anticoagulation at baseline (HR: 0.42; 95% CI: 0.26-0.69), antecedent use of statins (HR: 0.67; 95% CI: 0.50-0.90), and prophylactic anticoagulation during hospitalization (HR: 0.52; 95% CI: 0.38-0.71).

Conclusions:
While prior VTE, corticosteroid therapy, and known thrombophilia were associated with increased risk of VTE, prescriptions of anticoagulation and statins were associated with a decreased risk.
  • Scimeca, Giovanni  ( Brigham and Women's Hospital , Boston , Massachusetts , United States )
  • Porio, Nicole  ( Brigham and Women's Hospital , Boston , Massachusetts , United States )
  • Assi, Ali  ( Brigham and Women's Hospital , Boston , Massachusetts , United States )
  • Armero, Andre  ( Brigham and Women's Hospital , Boston , Massachusetts , United States )
  • Tristani, Anthony  ( Brigham and Women's Hospital , Boston , Massachusetts , United States )
  • Ortiz-rios, Marcos  ( Brigham and Women's Hospital , Boston , Massachusetts , United States )
  • Nauffal, Victor  ( Brigham and Women's Hospital , Boston , Massachusetts , United States )
  • Almarzooq, Zaid  ( Brigham and Women's Hospital , Boston , Massachusetts , United States )
  • Wei, Eric  ( Brigham and Women's Hospital , Boston , Massachusetts , United States )
  • Zuluaga-sanchez, Valeria  ( Brigham and Women's Hospital , Boston , Massachusetts , United States )
  • Zarghami, Mehrdad  ( Brigham and Women's Hospital , Boston , Massachusetts , United States )
  • Krishnathasan, Darsiya  ( Brigham and Women's Hospital , Boston , Massachusetts , United States )
  • Achanta, Aditya  ( Brigham and Women's Hospital , Boston , Massachusetts , United States )
  • Jesudasen, Sirus  ( Massachusetts General Hospital , Boston , Massachusetts , United States )
  • Tiu, Bruce  ( Brigham and Women's Hospital , Boston , Massachusetts , United States )
  • Merli, Geno  ( Thomas Jefferson University Hospital , Philadelphia , Pennsylvania , United States )
  • Fanikos, John  ( Brigham and Women's Hospital , Boston , Massachusetts , United States )
  • Leiva, Orly  ( Brigham and Women's Hospital , Boston , Massachusetts , United States )
  • Sharma, Aditya  ( University of Virginia Health , Charlottesville , Virginia , United States )
  • Rizzo, Samantha  ( Brigham and Women's Hospital , Boston , Massachusetts , United States )
  • Pfeferman, Mariana  ( Brigham and Women's Hospital , Boston , Massachusetts , United States )
  • Morrison, Ruth  ( Brigham and Women's Hospital , Boston , Massachusetts , United States )
  • Rashedi, Sina  ( Brigham and Women's Hospital , Boston , Massachusetts , United States )
  • Vishnevsky, Alec  ( Thomas Jefferson University Hospital , Philadelphia , Pennsylvania , United States )
  • Hsia, Judith  ( University of Colorado , Aurora , Colorado , United States )
  • Nehler, Mark  ( CPC Clinical Research , Aurora , Colorado , United States )
  • Welker, James  ( Anna Arundel Research Institute , Annapolis , Maryland , United States )
  • Bonaca, Marc  ( CPC Clinical Research , Aurora , Colorado , United States )
  • Carroll, Brett  ( Smith Center for Cardiovascular Outcomes Research , Boston , Massachusetts , United States )
  • Goldhaber, Samuel  ( Brigham and Women's Hospital , Boston , Massachusetts , United States )
  • Campia, Umberto  ( Brigham and Women's Hospital , Boston , Massachusetts , United States )
  • Bikdeli, Behnood  ( Brigham and Women's Hospital , Boston , Massachusetts , United States )
  • Piazza, Gregory  ( Brigham and Women's Hospital , Boston , Massachusetts , United States )
  • Sato, Alyssa  ( Brigham and Women's Hospital , Boston , Massachusetts , United States )
  • Lan, Zhou  ( Brigham and Women's Hospital , Boston , Massachusetts , United States )
  • Hamade, Nada  ( Brigham and Women's Hospital , Boston , Massachusetts , United States )
  • Bejjani, Antoine  ( Brigham and Women's Hospital , Boston , Massachusetts , United States )
  • Khairani, Candrika  ( Brigham and Women's Hospital , Boston , Massachusetts , United States )
  • Davies, Julia  ( Brigham and Women's Hospital , Boston , Massachusetts , United States )
  • Author Disclosures:
    Giovanni Scimeca: DO NOT have relevant financial relationships | Nicole Porio: DO NOT have relevant financial relationships | Ali Assi: No Answer | Andre Armero: DO NOT have relevant financial relationships | Anthony Tristani: DO NOT have relevant financial relationships | Marcos Ortiz-Rios: No Answer | Victor Nauffal: No Answer | Zaid Almarzooq: DO NOT have relevant financial relationships | Eric Wei: DO NOT have relevant financial relationships | Valeria Zuluaga-Sanchez: DO NOT have relevant financial relationships | Mehrdad Zarghami: DO NOT have relevant financial relationships | Darsiya Krishnathasan: DO NOT have relevant financial relationships | Aditya Achanta: No Answer | Sirus Jesudasen: No Answer | Bruce Tiu: No Answer | Geno Merli: No Answer | John Fanikos: No Answer | Orly Leiva: DO NOT have relevant financial relationships | Aditya Sharma: DO have relevant financial relationships ; Consultant:EnVVeno Medical:Active (exists now) ; Researcher:Vascular Medcure:Past (completed) ; Researcher:Boston Scientific Corporation :Active (exists now) ; Advisor:Novartis:Active (exists now) | Samantha Rizzo: DO NOT have relevant financial relationships | Mariana Pfeferman: DO NOT have relevant financial relationships | Ruth Morrison: No Answer | Sina Rashedi: No Answer | Alec Vishnevsky: No Answer | Judith Hsia: DO have relevant financial relationships ; Individual Stocks/Stock Options:AstraZeneca:Active (exists now) | Mark Nehler: No Answer | James Welker: No Answer | Marc Bonaca: DO have relevant financial relationships ; Research Funding (PI or named investigator):Dr. Bonaca is the Executive Director of CPC:Active (exists now) ; Research Funding (PI or named investigator):Dr. Bonaca is the Executive Director of CPC:Active (exists now) | Brett Carroll: DO have relevant financial relationships ; Advisor:Koya Medical:Active (exists now) ; Research Funding (PI or named investigator):Bristol Myers Squibb:Active (exists now) | Samuel Goldhaber: No Answer | Umberto Campia: DO NOT have relevant financial relationships | Behnood Bikdeli: DO have relevant financial relationships ; Research Funding (PI or named investigator):AHA:Active (exists now) ; Consultant:ICA and the US FDDA:Active (exists now) ; Consultant:Litigation related to IVC filters, on behalf of the plaintiff:Past (completed) ; Research Funding (PI or named investigator):BWH:Active (exists now) | Gregory Piazza: No Answer | Alyssa Sato : DO NOT have relevant financial relationships | Zhou Lan: DO NOT have relevant financial relationships | Nada Hamade: No Answer | Antoine Bejjani: No Answer | Candrika Khairani: No Answer | Julia Davies: No Answer
Meeting Info:

Scientific Sessions 2024

2024

Chicago, Illinois

Session Info:

Venous Thromboembolism: Approaching Never Events?

Saturday, 11/16/2024 , 11:10AM - 12:35PM

Moderated Digital Poster Session

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