Comparison of Direct Oral Anticoagulants and Warfarin in the Treatment of Deep Venous Thrombosis in the Chronic Phase
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- Wakakura Shingo
- Department of Cardiovascular Medicine, Toho University Faculty of Medicine
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- Hara Fumihiko
- Department of Cardiovascular Medicine, Toho University Faculty of Medicine
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- Fujino Tadashi
- Department of Cardiovascular Medicine, Toho University Faculty of Medicine
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- Hamai Asami
- Department of Cardiovascular Medicine, Toho University Faculty of Medicine
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- Ohara Hiroshi
- Department of Cardiovascular Medicine, Toho University Faculty of Medicine
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- Kabuki Takayuki
- Department of Cardiovascular Medicine, Toho University Faculty of Medicine
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- Harada Masahiko
- Department of Cardiovascular Medicine, Toho University Faculty of Medicine
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- Ikeda Takanori
- Department of Cardiovascular Medicine, Toho University Faculty of Medicine
Bibliographic Information
- Other Title
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- A Large, Single-Center, Observational Study
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Abstract
<p>We assessed the efficacy and safety of direct oral anticoagulants (DOACs) for the treatment of deep venous thrombosis (DVT) in the chronic phase through comparison with conventional warfarin therapy.</p><p>A total of 807 consecutive patients who were diagnosed with having DVT in the chronic phase were included (484 patients to warfarin therapy and 323 patients to DOAC therapy). The condition of leg veins was assessed 3 to 6 months after starting the therapies by ultrasound examination. Major bleeding and mortality during the therapies were followed-up.</p><p>There was no significant difference between the two groups in the thrombosis improvement rate (DOAC group: 91.2% versus warfarin group: 88.9%). There was no significant difference between the two groups in major bleeding (DOAC group: 1.8% versus warfarin group: 1.8%). In patients with active cancer, the DOAC group had a borderline higher thrombosis improvement rate than the warfarin group (92.1% versus 80.0%, P = 0.05). The proportion of major bleeding in the patients with active cancer was slightly higher in the warfarin group than in the DOAC group (4.3% versus 2.8%; P = 0.71). Active cancer was not an independent risk factor for major bleeding and recurrence in the DOAC group (OR 2.68, 95% CI 0.51-14.1; P = 0.24 and OR 0.65, 95% CI 0.20-2.07; P = 0.47).</p><p>In treatment using oral anticoagulants for DVT in the chronic phase, DOACs exhibited equal efficacy and safety as warfarin did. Particularly DOACs appear to be an attractive therapeutic option for cancer-associated DVT in chronic phase, with relatively low anticipated rates of recurrence and major bleeding.</p>
Journal
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- International Heart Journal
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International Heart Journal 59 (1), 126-135, 2018
International Heart Journal Association
