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

Cohen, O.; Barg, A. A.; Nowak-Gottl, U.; Amado-Fernandez, C.; Mazzolai, L.; Tiberio, G.; Schellong, S.; Skride, A.; Morales, M. D. V.; Monreal, M.; Kenet, G.; Prandoni, P.; Brenner, B.; Farge-Bancel, D.; Barba, R.; Di Micco, P.; Bertoletti, L.; Tzoran, I.; Reis, A.; Bosevski, M.; Bounameaux, H.; Maly, R.; Verhamme, P.; Caprini, J. A.; Bui, H. M.; Adarraga, M. D.; Alberich-Conesa, A.; Alonso-Carrillo, J.; Amado, C.; Amoros, S.; Arcelus, J. I.; Ballaz, A.; Barba, R.; Barbagelata, C.; Barron, M.; Barron-Andres, B.; Blanco-Molina, A.; Botella, E.; Casado, I.; Chasco, L.; Cerda, P.; Criado, J.; del Toro, J.; De Juana-Izquierdo, C.; Demelo-Rodriguez, P.; Diaz-Brasero, A. M.; Diaz-Pedroche, M. C.; Diaz-Peromingo, J. A.; Dubois-Silva, A.; Escribano, J. C.; Esposito, F.; Falga, C.; Fernandez-Capitan, C.; Fernandez-Jimenez, B.; Fernandez-Muixi, J.; Fernandez-Reyes, J. L.; Fidalgo, M. A.; Font, C.; Francisco, I.; Galeano-Valle, F.; Garcia, M. A.; Garcia de Herreros, M.; Garcia-Bragado, F.; Garcia-Ortega, A.; Gavin-Sebastian, O.; Gil-Diaz, A.; Gomez-Cuervo, C.; Gomez-Mosquera, A. M.; Gonzalez-Martinez, J.; Gonzalez-Moreno, M.; Grau, E.; Guirado, L.; Gutierrez, J.; Hernandez-Blasco, L.; Jaras, M. J.; Jimenez, D.; Jou, I.; Joya, M. D.; Lacruz, B.; Lainez-Justo, S.; Lalueza, A.; Latorre, A.; Lecumberri, R.; Lobo, J. L.; Lopez-De la Fuente, M.; Lopez-Jimenez, L.; Lopez-Miguel, P.; Lopez-Nunez, J. J.; Lopez-Ruiz, A.; Lopez-Saez, J. B.; Lorenzo, A.; Lumbierres, M.; Madridano, O.; Maestre, A.; Marcos, M.; Martin-Martos, F.; Mellado, M.; Mena, E.; Mercado, M. I.; Moises, J.; Monreal, M.; Munoz-Blanco, A.; Munoz-Gamito, G.; Morales, M. V.; Nieto, J. A.; Noguera-Gras, E.; Nunez-Fernandez, M. J.; Osorio, J.; Otalora, S.; Pacheco-Gomez, N.; Paredes-Ruiz, D.; Parra, P.; Pedrajas, J. M.; Perez-Ductor, C.; Perez-Jacoiste, M. A.; Perez-Perez, J. L.; Peris, M. L.; Porras, J. A.; Poyo-Molina, J.; Puchades, R.; Riera-Mestre, A.; Rivera-Civico, F.; Rivera-Gallego, A.; Roca, M.; Rosa, V.; Rodriguez-Cobo, A.; Ruiz-Gimenez, N.; Salgueiro, G.; Sancho, T.; Sendin, V.; Siguenza, P.; Soler, S.; Surinach, J. M.; Tiberio, G.; Torres, M. I.; Trujillo-Santos, J.; Uresandi, F.; Usandizaga, E.; Valle, R.; Varona, J. F.; Vela, L.; Vela, J. R.; Villalobos, A.; Villares, P.; Ay, C.; Nopp, S.; Pabinger, I.; Engelen, M. M.; Martens, C.; Verhamme, P.; Yoo, H. H. B.; Arguello, J. D.; Montenegro, A. C.; Roa, J.; Hirmerova, J.; Maly, R.; Accassat, S.; Bertoletti, L.; Bura-Riviere, A.; Catella, J.; Chopard, R.; Couturaud, F.; Espitia, O.; Leclercq, B.; Le Mao, R.; Mahe, I.; Moustafa, F.; Plaisance, L.; Poenou, G.; Sarlon-Bartoli, G.; Suchon, P.; Versini, E.; Schellong, S.; Braester, A.; Kenet, G.; Tzoran, I.; Sadeghipour, P.; Basaglia, M.; Bilora, F.; Bortoluzzi, C.; Brandolin, B.; Ciammaichella, M.; Colaizzo, D.; De Angelis, A.; Dentali, F.; Di Micco, P.; Grandone, E.; Imbalzano, E.; Merla, S.; Pesavento, R.; Prandoni, P.; Scarinzi, P.; Siniscalchi, C.; Tufano, A.; Visona, A.; Vo Hong, N.; Zalunardo, B.; Gibietis, V.; Kigitovica, D.; Skride, A.; Fonseca, S.; Manuel, M.; Meireles, J.; Bosevski, M.; Bounameaux, H.; Mazzolai, L.; Aujayeb, A.; Caprini, J. A.; Weinberg, I.; Bui, H. M.

doi:10.1016/j.jtha.2023.06.031

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.