Low Body Weight and Long-term Outcomes in Patients with Venous Thromboembolism: Insights from the COMMAND VTE Registry-2

Major bleeding and recurrent venous thromboembolism (VTE) both lead to a poor prognosis among patients with VTE. Low body weight (BW) may be a risk factor for bleeding; however, data on its impact remain limited in the direct oral anticoagulant (DOAC) era.We investigated the relationship between low BW and long-term outcomes among VTE patients in the DOAC era.From the COMMAND VTE Registry-2 in Japan between January 2015 and August 2020, we analyzed 4,959 patients with symptomatic VTE, who were divided into low BW (≤60 kg) (<i>N</i> = 2,897) and non-low BW (>60 kg) (<i>N</i> = 2,062) groups. The primary outcome was major bleeding.The low BW group was older (71.3 vs. 62.5 years, <i>P</i> < 0.001), included a higher percentage of female (75% vs. 36%, <i>P</i> < 0.001), and received initial intensive DOAC therapy less often (64% vs. 75%, <i>P</i> < 0.001) and reduced maintenance DOAC doses more frequently (51% vs. 15%, <i>P</i> < 0.001) than the non-low BW group. The risks of major bleeding (16.7% vs. 10.8% at 5 years; adjusted HR 1.43, 95%CI 1.15-1.77, <i>P</i> = 0.001) and all-cause death (38.9% vs. 23.2%; HR 1.59, 95%CI 1.39-1.81, <i>P</i> < 0.001) were higher in the low BW group than in the non-low BW group, while the risk of recurrent VTE was similar (9.4% vs. 9.7%; HR 0.98, 95%CI 0.75-1.29, <i>P</i> = 0.90).Low BW correlated with higher risks of major bleeding and all-cause death, but not recurrent VTE in the DOAC era.

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Journal
Thrombosis and Haemostasis
Published
2025-12-03
DOI
https://doi.org/10.1055/a-2760-8218
Primary Topic
Venous Thromboembolism Diagnosis and Management
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article
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article

Low Body Weight and Long-term Outcomes in Patients with Venous Thromboembolism: Insights from the COMMAND VTE Registry-2

Kiyonori Togi, Kazunori Otsui, Shunsuke Usami, Shuhei Tsuji et al.
Thrombosis and Haemostasis
Venous Thromboembolism Diagnosis and Management
article

Low Body Weight and Long-term Outcomes in Patients with Venous Thromboembolism: Insights from the COMMAND VTE Registry-2

Kiyonori Togi, Kazunori Otsui, Shunsuke Usami, Shuhei Tsuji, Wataru Shioyama, Kaoru Dohi, Ryuki Chatani, Norimichi Koitabashi, Kensuke Takabayashi, Seiichi Hiramori, Takuma Takeda, Daisuke Sueta, Yugo Yamashita, Jiro Sakamoto, Toru Takase, Kazuhisa Kaneda, Tomohiro Dohke, Moriaki Inoko, Yoshito Ogihara, Nobutaka Ikeda, Yuji Nishimoto, Takeshi Morimoto, Yoshiaki Tsuyuki, Takeshi Kimura, Kitae Kim, Hiroshi Mabuchi, Koichiro Murata, Tôru Satô, Maki Oi, Satoshi Ikeda, Yohei Kobayashi, Takeshi Inoue, Ryusuke Nishikawa, Po‐Min Chen, S Kobayashi, Hisato Nakai, Kosuke Doi
article en

Abstract

Major bleeding and recurrent venous thromboembolism (VTE) both lead to a poor prognosis among patients with VTE. Low body weight (BW) may be a risk factor for bleeding; however, data on its impact remain limited in the direct oral anticoagulant (DOAC) era.We investigated the relationship between low BW and long-term outcomes among VTE patients in the DOAC era.From the COMMAND VTE Registry-2 in Japan between January 2015 and August 2020, we analyzed 4,959 patients with symptomatic VTE, who were divided into low BW (≤60 kg) (<i>N</i> = 2,897) and non-low BW (>60 kg) (<i>N</i> = 2,062) groups. The primary outcome was major bleeding.The low BW group was older (71.3 vs. 62.5 years, <i>P</i> < 0.001), included a higher percentage of female (75% vs. 36%, <i>P</i> < 0.001), and received initial intensive DOAC therapy less often (64% vs. 75%, <i>P</i> < 0.001) and reduced maintenance DOAC doses more frequently (51% vs. 15%, <i>P</i> < 0.001) than the non-low BW group. The risks of major bleeding (16.7% vs. 10.8% at 5 years; adjusted HR 1.43, 95%CI 1.15-1.77, <i>P</i> = 0.001) and all-cause death (38.9% vs. 23.2%; HR 1.59, 95%CI 1.39-1.81, <i>P</i> < 0.001) were higher in the low BW group than in the non-low BW group, while the risk of recurrent VTE was similar (9.4% vs. 9.7%; HR 0.98, 95%CI 0.75-1.29, <i>P</i> = 0.90).Low BW correlated with higher risks of major bleeding and all-cause death, but not recurrent VTE in the DOAC era.

Thrombosis and Haemostasis
Toho University (JP), Hyogo Medical University (JP), Shiga University of Medical Science (JP), Gunma University (JP), Mie University (JP), Kyoto University (JP), Tenri Hospital (JP), Kyoto Medical Center (JP), Taoka Hospital (JP), Osaka Kaisei Hospital (JP), Toyonaka Municipal Hospital (JP), Kurashiki Central Hospital (JP), Kobe University Hospital (JP), Toho University Ohashi Medical Center (JP), Kindai University Hospital (JP), Kansai Electric Power Hospital (JP), Shimada Municipal Hospital (JP), Shizuoka City Hospital (JP), Otsu Red Cross Hospital (JP), Tokyo Women's Medical University (JP), Saiseikai Nakatsu Hospital (JP), Koto Hospital (JP), Osaka Red Cross Hospital (JP), Japanese Red Cross Society Wakayama Medical Center (JP), Shiga Medical Center (JP), Saiseikai Ibaraki Hospital (JP), Kitano Hospital (JP), Kokura Memorial Hospital (JP), Kobe City Medical Center General Hospital (JP), Municipal Hirakata City Hospital (JP), Nagasaki University (JP), Kindai University (JP), Kumamoto University (JP)
Openalex Percentile: Top 41%
Venous Thromboembolism Diagnosis and Management
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