Table 2.

VTE treatment strategies according to IT testing, its results, and by thrombophilia subgroups

Not testedTestedPositive IT (ALL IT types)Protein C deficiency
only		Protein S deficiency
only		Antithrombin deficiency
only		Factor V
Leiden only		Prothrombin mutation
only		Combined ITNegative IT
Patients, n 82 729 21 089 8422 294 726 240 2248 1434 3480 12 667 
Initial therapy           
LMWH 71 327 (86%) 18 097 (86%) 7387 (88%)∗  258 (88%) 649 (89%)†  206 (86%) 1946 (87%) 1276 (89%)‡  3052 (88%)†  10 710 (85%)∗  
UFH 4402 (5.3%) 1201 (5.7%)†  411 (4.9%) 19 (6.5%) 31 (4.3%) 21 (8.8%)†  77 (3.4%)∗  69 (4.8%) 194 (5.6%) 790 (6.2%)∗  
Fondaparinux 1883 (2.3%) 417 (2.0%)‡  192 (2.3%) 3 (1.0%) 7 (1.0%)†  7 (2.9%) 77 (3.4%)∗  28 (2.0%) 70 (2.0%) 225 (1.8%)∗  
DOACs 3193 (3.9%) 759 (3.6%) 225 (2.7%)∗  7 (2.4%) 17 (2.4%)†  2 (0.8%)†  99 (4.4%) 25 (1.7%)∗  75 (2.2%)∗  534 (4.2%) 
Rivaroxaban 2122 (2.6%) 637 (3.0%)∗  175 (2.1%)‡  5 (1.7%) 12 (1.7%) 2 (0.8%) 82 (3.6%)‡  20 (1.4%)‡  54 (1.6%)∗  462 (3.6%)∗  
Apixaban 969 (1.2%) 112 (0.5%)∗  45 (0.53%)∗  2 (0.7%) 4 (0.5%) 0 15 (0.7%)†  5 (0.3%)‡  19 (0.5%)∗  67 (0.5%)∗  
Systemic thrombolysis 472 (0.6%) 92 (0.5%)‡  38 (0.49%) 1 (0.4%) 3 (0.4%) 4 (1.8%) 7 (0.3%) 6 (0.4%) 17 (0.5%) 54 (0.5%)†  
Mechanical thrombolysis 343 (1.1%) 94 (1.3%) 43 (1.6%)†  0 7 (3.1%)†  1 (1.4%) 9 (1.2%) 9 (1.9%) 17 (1.7%) 51 (1.1%) 
Inferior vena cava filter 2167 (2.6%) 421 (2.0%)∗  170 (2.0%)∗  7 (2.4%) 19 (2.6%) 10 (4.2%) 38 (1.7%)‡  24 (1.7%)†  72 (2.1%)†  251 (2.0%)∗  
No anticoagulant therapy 319 (0.4%) 44 (0.2%)∗  18 (0.21%)†  0 4 (0.5%) 0 5 (0.2%) 4 (0.3%) 5 (0.1%)†  26 (0.2%)‡  
Long-term therapy           
LMWH 25 872 (31%) 4634 (22%)∗  1773 (21%)∗  35 (12%)∗  176 (24%)∗  51 (21%)∗  443 (20%)∗  303 (21%)∗  765 (22%)∗  2861 (23%)∗  
VKAs 40 548 (49%) 13 629 (65%)∗  5588 (66%)∗  224 (76%)∗  467 (64%)∗  165 (69%)∗  1434 (64%)∗  962 (67%)∗  2336 (67%)∗  8041 (63%)∗  
DOACs 11 790 (15%) 2399 (11%)∗  884 (11%)∗  28 (9.7%)†  69 (9.6%)∗  14 (5.9%)∗  323 (14%) 154 (11%)∗  296 (8.6%)∗  1515 (12%)∗  
Rivaroxaban 5946 (7.2%) 1508 (7.2%) 523 (6.2%)∗  19 (6.5%) 41 (5.6%) 12 (5.0%) 205 (9.1%)∗  76 (5.3%)‡  170 (4.9%)∗  985 (7.8%)†  
Apixaban 4049 (4.9%) 514 (2.4%)∗  203 (2.4%)∗  8 (2.7%) 13 (1.8%)∗  0 65 (2.9%)∗  37 (2.6%)∗  80 (2.3%)∗  311 (2.5%)∗  
Edoxaban 1442 (1.7%) 279 (1.3%)∗  113 (1.3%)‡  1 (0.3%) 11 (1.5%) 1 (0.4%) 35 (1.6%) 30 (2.1%) 35 (1.0%)‡  166 (1.3%)∗  
Dabigatran 353 (0.4%) 98 (0.5%) 45 (0.53%) 0 4 (0.5%) 1 (0.4%) 18 (0.8%)†  11 (0.8%) 11 (0.3%) 53 (0.4%) 
Fondaparinux 830 (1.0%) 148 (0.7%)∗  80 (0.95%) 2 (0.7%) 3 (0.4%) 5 (2.1%) 25 (1.1%) 7 (0.5%) 38 (1.1%) 68 (0.5%)∗  
No anticoagulant therapy 634 (0.8%) 64 (0.3%)∗  24 (0.28%)∗  2 (0.7%) 1 (0.14%) 2 (0.8%) 7 (0.3%)†  3 (0.2%)†  9 (0.3%)∗  40 (0.3%)∗  
Not testedTestedPositive IT (ALL IT types)Protein C deficiency
only		Protein S deficiency
only		Antithrombin deficiency
only		Factor V
Leiden only		Prothrombin mutation
only		Combined ITNegative IT
Patients, n 82 729 21 089 8422 294 726 240 2248 1434 3480 12 667 
Initial therapy           
LMWH 71 327 (86%) 18 097 (86%) 7387 (88%)∗  258 (88%) 649 (89%)†  206 (86%) 1946 (87%) 1276 (89%)‡  3052 (88%)†  10 710 (85%)∗  
UFH 4402 (5.3%) 1201 (5.7%)†  411 (4.9%) 19 (6.5%) 31 (4.3%) 21 (8.8%)†  77 (3.4%)∗  69 (4.8%) 194 (5.6%) 790 (6.2%)∗  
Fondaparinux 1883 (2.3%) 417 (2.0%)‡  192 (2.3%) 3 (1.0%) 7 (1.0%)†  7 (2.9%) 77 (3.4%)∗  28 (2.0%) 70 (2.0%) 225 (1.8%)∗  
DOACs 3193 (3.9%) 759 (3.6%) 225 (2.7%)∗  7 (2.4%) 17 (2.4%)†  2 (0.8%)†  99 (4.4%) 25 (1.7%)∗  75 (2.2%)∗  534 (4.2%) 
Rivaroxaban 2122 (2.6%) 637 (3.0%)∗  175 (2.1%)‡  5 (1.7%) 12 (1.7%) 2 (0.8%) 82 (3.6%)‡  20 (1.4%)‡  54 (1.6%)∗  462 (3.6%)∗  
Apixaban 969 (1.2%) 112 (0.5%)∗  45 (0.53%)∗  2 (0.7%) 4 (0.5%) 0 15 (0.7%)†  5 (0.3%)‡  19 (0.5%)∗  67 (0.5%)∗  
Systemic thrombolysis 472 (0.6%) 92 (0.5%)‡  38 (0.49%) 1 (0.4%) 3 (0.4%) 4 (1.8%) 7 (0.3%) 6 (0.4%) 17 (0.5%) 54 (0.5%)†  
Mechanical thrombolysis 343 (1.1%) 94 (1.3%) 43 (1.6%)†  0 7 (3.1%)†  1 (1.4%) 9 (1.2%) 9 (1.9%) 17 (1.7%) 51 (1.1%) 
Inferior vena cava filter 2167 (2.6%) 421 (2.0%)∗  170 (2.0%)∗  7 (2.4%) 19 (2.6%) 10 (4.2%) 38 (1.7%)‡  24 (1.7%)†  72 (2.1%)†  251 (2.0%)∗  
No anticoagulant therapy 319 (0.4%) 44 (0.2%)∗  18 (0.21%)†  0 4 (0.5%) 0 5 (0.2%) 4 (0.3%) 5 (0.1%)†  26 (0.2%)‡  
Long-term therapy           
LMWH 25 872 (31%) 4634 (22%)∗  1773 (21%)∗  35 (12%)∗  176 (24%)∗  51 (21%)∗  443 (20%)∗  303 (21%)∗  765 (22%)∗  2861 (23%)∗  
VKAs 40 548 (49%) 13 629 (65%)∗  5588 (66%)∗  224 (76%)∗  467 (64%)∗  165 (69%)∗  1434 (64%)∗  962 (67%)∗  2336 (67%)∗  8041 (63%)∗  
DOACs 11 790 (15%) 2399 (11%)∗  884 (11%)∗  28 (9.7%)†  69 (9.6%)∗  14 (5.9%)∗  323 (14%) 154 (11%)∗  296 (8.6%)∗  1515 (12%)∗  
Rivaroxaban 5946 (7.2%) 1508 (7.2%) 523 (6.2%)∗  19 (6.5%) 41 (5.6%) 12 (5.0%) 205 (9.1%)∗  76 (5.3%)‡  170 (4.9%)∗  985 (7.8%)†  
Apixaban 4049 (4.9%) 514 (2.4%)∗  203 (2.4%)∗  8 (2.7%) 13 (1.8%)∗  0 65 (2.9%)∗  37 (2.6%)∗  80 (2.3%)∗  311 (2.5%)∗  
Edoxaban 1442 (1.7%) 279 (1.3%)∗  113 (1.3%)‡  1 (0.3%) 11 (1.5%) 1 (0.4%) 35 (1.6%) 30 (2.1%) 35 (1.0%)‡  166 (1.3%)∗  
Dabigatran 353 (0.4%) 98 (0.5%) 45 (0.53%) 0 4 (0.5%) 1 (0.4%) 18 (0.8%)†  11 (0.8%) 11 (0.3%) 53 (0.4%) 
Fondaparinux 830 (1.0%) 148 (0.7%)∗  80 (0.95%) 2 (0.7%) 3 (0.4%) 5 (2.1%) 25 (1.1%) 7 (0.5%) 38 (1.1%) 68 (0.5%)∗  
No anticoagulant therapy 634 (0.8%) 64 (0.3%)∗  24 (0.28%)∗  2 (0.7%) 1 (0.14%) 2 (0.8%) 7 (0.3%)†  3 (0.2%)†  9 (0.3%)∗  40 (0.3%)∗  

Patients not tested for IT were used as reference for all comparisons with the remaining subgroups.

DVT, deep venous thrombosis; DOACs, direct oral anticoagulants; LMWH, low molecular-weight heparin; UFH, unfractionated heparin; VKAs, vitamin K antagonists.

∗

P < .001.

†

P < .05.

‡

P < .01.

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