title: Current venous thromboembolism management and outcomes in Japan.
abstract: BACKGROUND
  Epidemiology and clinical management of acute venous thromboembolism (VTE) are not readily available in Japan.
  
  
  RESULTS
  The Japan VTE Treatment Registry (JAVA) is a multicenter cohort study of consecutive patients with an objectively confirmed, symptomatic acute pulmonary embolism (PE), symptomatic acute deep vein thrombosis (DVT), or asymptomatic acute proximal DVT. Of the 1,076 patients enrolled with acute VTE, 68.7% presented with an isolated DVT; 17.0% had PE alone; and 14.4% had both. VTE management was characterized by a high rate of inferior vena cava filter insertion (40.6%), frequent thrombolysis (21.1%), and sub-therapeutic unfractionated heparin-based anticoagulation, followed by warfarin prescription, mostly targeting an international normalized ratio of 2.0 (range, 1.5-2.5). During a mean observation period of 252.5 days, 29 recurrent cases of VTE were documented, yielding an incidence rate of 3.9 per 100 patient-years. A total of 123 patients died during the study period, corresponding to a rate of 16.6 deaths per 100 patient-years. The incidence of major bleeding was 3.2% per patient-year, including 2 fatal hemorrhages and 7 intracranial hemorrhages.
  
  
  CONCLUSIONS
  VTE management in Japan is characterized by a highly aggressive strategy in the acute phase, in contrast to protocols that use low-level anticoagulation. The VTE recurrence rates in Japan and Western countries are similar, but mortality is higher in Japan, with significant variability depending on patient and management characteristics.
authors.affiliation: Department of Clinical Cardiovascular Research, Graduate School of Medicine, Mie University.
authors.forename: Mashio
authors.initials: M
authors.lastname: Nakamura
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Miyata
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Ozeki
authors.forename: Morimasa
authors.initials: M
authors.lastname: Takayama
authors.forename: Kimihiro
authors.initials: K
authors.lastname: Komori
authors.forename: Norikazu
authors.initials: N
authors.lastname: Yamada
authors.forename: Hideki
authors.initials: H
authors.lastname: Origasa
authors.forename: Hirono
authors.initials: H
authors.lastname: Satokawa
authors.forename: Hideaki
authors.initials: H
authors.lastname: Maeda
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Tanabe
authors.forename: Naoki
authors.initials: N
authors.lastname: Unno
authors.forename: Takashi
authors.initials: T
authors.lastname: Shibuya
authors.forename: Kazuo
authors.initials: K
authors.lastname: Tanemoto
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Kondo
authors.forename: Tetsuhito
authors.initials: T
authors.lastname: Kojima
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D019934:International Normalized Ratio; D020300:Intracranial Hemorrhages / Q000209:etiology / Q000401:mortality; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015912:Thrombolytic Therapy / Q000379:methods; D016306:Vena Cava Filters; D054556:Venous Thromboembolism / Q000401:mortality* / Q000628:therapy*; D014859:Warfarin / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D000925:Anticoagulants; D014859:Warfarin