P5586Predictors for not initiating anticoagulant treatment after incident venous thromboembolism: a Danish nationwide study

Abstract Background Venous thromboembolism (VTE) is common and potentially fatal. Anticoagulation is the treatment cornerstone but up to one-third do not initiate treatment after incident VTE. Identification of patient characteristics associated with non-initiation may enable identification of individuals in need of additional patient education and intensified clinical follow-up. Purpose To investigate characteristics associated with not initiating anticoagulation after incident VTE in a Danish nationwide study. Methods We linked nationwide Danish health registries to identify consecutive patients with incident VTE between 2000–2016. The outcome was not initiating anticoagulant treatment (warfarin or NOAC) within 30 days after incident VTE diagnosis. Logistic regression was used to identify predictors of treatment non-initiation. Results Among 85,046 patients with incident VTE, 41% (n=34,877) patients had not redeemed a prescription of anticoagulation within 30 days after incident VTE. Age65 years 43,520 (51.2%) Ref. Females, n (%) 45,119 (53.1%) 1.40 (1.36; 1.44) Unprovoked VTE§, n (%) 53,779 (63.2%) 1.08 (1.06; 1.12) Chronic diseases 10 years within incident VTE Inflammatory disease¶, n (%) 7,374 (8.7%) 1.07 (1.02; 1.14) Heart Failure, n (%) 6,242 (7.3%) 1.21 (1.11; 1.32) Ischemic heart disease, n (%) 11,025 (13.0%) 1.25 (1.19; 1.32) Chronic obstructive pulmonary disease, n (%) 8,385 (9.9%) 1.02 (0.96; 1.08) Kidney disease, n (%) 2,626 (3.1%) 1.21 (1.12; 1.32) Diabetes, n (%) 6,884 (8.1%) 1.13 (1.06; 1.20) Hypertension, n (%) 233,651 (27.8%) 0.99 (0.94; 1.05) Chronic diseases, n (%) 0 chronic diseases 46,036 (54.1%) Ref. 1–2 chronic diseases 30,462 (35.8%) 1.09 (1.03; 1.15) >3 chronic diseases 8,548 (10.1%) 1.12 (0.98; 1.28) *Venous thromboembolism. †Defined as not redeeming a prescription on anticoagulant medicine no later than 30 days after an incident VTE diagnosis. ‡Adjusted for age, sex and other baseline characteristics. §Defined as absence o