Key result
NOAC therapy for proximal deep vein thrombosis resulted in significantly higher average free lumen values at 180 days compared to conventional treatment (85% vs 73%; p=0.0001).
Why the study?
To evaluate the efficacy and recanalization rate of NOACs compared to conventional treatment in deep vein thrombosis of the proximal segments of lower extremities.
Do novel oral anticoagulants improve the rate of recanalization compared to conventional treatment in patients with proximal deep vein thrombosis?
Cohort (n=200)
Do novel oral anticoagulants improve the rate of recanalization compared to conventional treatment in patients with proximal deep vein thrombosis?
Absolute Event Rate: 85% vs 73%
p-value: p=0.0001
NOAC therapy is associated with a significantly higher rate of venous recanalization compared to conventional LMWH and vitamin K antagonist therapy in patients with proximal DVT.
NOAC may improve venous patency in proximal DVT; hypothesis-generating and requires randomized confirmation before practice change.
Aim To evaluate the efficacy (rate of recanalization) of therapy with novel oral anticoagulants (NOAC; rivaroxaban, apixaban) compared to conventional treatment (low molecular weight heparin - LMWH and vitamin K antagonist) in the treatment of deep vein thrombosis (DVT) of the proximal segments of lower extremities. Methods The first group consisted of patients diagnosed with DVT and treated with NOAC (n = 100), while the second group consisted of patients diagnosed with DVT, who were treated by conventional treatment (low molecular weight heparin and vitamin K antagonists) (n = 100). In the first group, NOAC was included in the initial treatment. Patients in the second group were treated with LMWH for four days, and on the fifth day vitamin K antagonist was included in therapy, international ratio (INR) was titrated to therapeutic values (2.0-3.0), and then low molecular weight heparin was excluded from the therapy. Results There was a statistically significant difference in the estimated values of free lumen of the blood vessel between the examined groups after 30 days (p=0.0001), after 90 days (p=0.0001) and after 180 days (p=0.0001). After 180 days, the average free lumen values in the NOAC group were 85% (81-89%), which was significantly higher than the free lumen values in the second group, 73% (69-79%). Conclusion The use of NOAC represents more efficient treatment of DVT comparing to vitamin K antagonists.
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Begić et al. (2022) conducted a cohort in Deep vein thrombosis (DVT) of the proximal segments of lower extremities (n=200). NOAC (rivaroxaban, apixaban) vs. Conventional treatment (low molecular weight heparin and vitamin K antagonists) was evaluated on Average free lumen values of the blood vessel after 180 days (p=0.0001). NOAC therapy for proximal deep vein thrombosis resulted in significantly higher average free lumen values at 180 days compared to conventional treatment (85% vs 73%; p=0.0001).
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