Do direct oral anticoagulants (DOACs) reduce mortality, recurrent VTE, and major bleeding compared to vitamin K antagonists (VKAs) in patients discharged with acute pulmonary embolism?
In a real-world Croatian cohort, DOACs were associated with lower mortality and bleeding risk compared to VKAs in patients with acute pulmonary embolism.
BACKGROUND: Pulmonary embolism (PE) is a major cause of cardiovascular morbidity and mortality. Guidelines favor direct oral anticoagulants (DOACs) over vitamin K antagonists (VKAs), but real-world Croatian data are scarce. METHODS: A prospective dual-center registry included 773 patients discharged with acute PE between 2013 and 2024. Clinical, laboratory, and socioeconomic data were collected. The primary outcome was all-cause mortality; secondary outcomes were recurrent venous thromboembolism (VTE) and major bleeding. RESULTS: < 0.001). Higher PESI class independently increased mortality and recurrence. CONCLUSION: In the first Croatian PE cohort, DOACs were linked to reduced mortality and bleeding risk compared with VKAs, with similar recurrence. Clinical, socioeconomic, and policy factors strongly influenced prescribing patterns and outcomes.
Jurin et al. (Mon,) studied this question.