Prescription patterns of direct oral anticoagulants in pulmonary embolism: A prospective multicenter French registry.

Autor: Chopard R; Department of Cardiology, EA3920, University Hospital Besançon, Boulevard Fleming, 25030 Besançon, France. Electronic address: chopardromain@yahoo.fr., Andarelli JN; Department of Cardiology, EA3920, University Hospital Besançon, Boulevard Fleming, 25030 Besançon, France., Humbert S; Department of Internal Medicine, Hospital Besançon, Boulevard Fleming, 25030 Besançon, France. Electronic address: shumbert@chu-besancon.fr., Falvo N; Department of Internal Medicine, University hospital, 2 Boulevard du Maréchal de Lattre de Tassigny, 21000 Dijon, France. Electronic address: nicolas.falvo@chu-dijon.fr., Morel-Aleton M; Department of Cardiology, General Hospital, 2 Faubourg Saint Etienne, 25300 Pontarlier, France., Bonnet B; Department of Cardiology, General Hospital of Vesoul, 2 Avenue René Heymes, 70000 Vesoul, France. Electronic address: bbonnet@chu-besancon.fr., Napporn G; Department of Cardiology, Hospital center Louis Pasteur, 73 Avenue Léon Jouhaux, 39100 Dole, France. Electronic address: cardiologie.secretariat@ch-dole.fr., Kalbacher E; Medical Oncology Unit, University Hospital Besançon, Boulevard Fleming, 25030 Besançon, France. Electronic address: ekalbacher@chu-besancon.fr., Obert L; Orthopedic, Trauma, Plastic, Reconstructive and Hand Surgery Department, University Hospital Besançon, Boulevard Fleming, 25030 Besançon, France. Electronic address: lobert@chu-besancon.fr., Degano B; Department of Physiology, EA3920, University Hospital Besançon, Boulevard Fleming, 25030 Besançon, France. Electronic address: bdegano@chu-besancon.fr., Cappelier G; Medical Intensive Care Unit, EA3920, University Hospital Besançon, Boulevard Fleming, 25030 Besançon, France. Electronic address: gilles.capellier@univ-fcomte.fr., Cottin Y; Department of Cardiology, University Hospital, 2 Boulevard du Maréchal de Lattre de Tassigny, 21000 Dijon, France. Electronic address: yves.cottin@chu-dijon.fr., Schiele F; Department of Cardiology, EA3920, University Hospital Besançon, Boulevard Fleming, 25030 Besançon, France. Electronic address: francois.schiele@univ-fcomte.fr., Meneveau N; Department of Cardiology, EA3920, University Hospital Besançon, Boulevard Fleming, 25030 Besançon, France. Electronic address: nicolas.meneveau@univ-fcomte.fr.
Jazyk: angličtina
Zdroj: Thrombosis research [Thromb Res] 2019 Feb; Vol. 174, pp. 27-33. Date of Electronic Publication: 2018 Dec 08.
DOI: 10.1016/j.thromres.2018.12.013
Abstrakt: Background: Data regarding the use of direct oral anticoagulants (DOACs) for the treatment of acute pulmonary embolism (PE) are sparse. We conducted a prospective multicentre registry study to describe patterns of DOAC prescription for the treatment of acute PE, and the associated risk of 6-month adverse events in daily practice.
Methods: We included all PE patients discharged since the availability of DOACs for the dedicated indication of acute PE treatment. Clinical data and 6-month outcomes, including death, recurrent venous thromboembolism (VTE), bleeding, and chronic thromboembolic pulmonary hypertension (CTEPH) were recorded prospectively. Temporal trends in DOAC prescription were tested.
Results: Between 09/2012 and 04/2017, 1082 patients were included: 60.6% (n = 656) were treated with DOACs and 39.4% (n = 426) with another anticoagulant. The prescription rate of DOACs increased sharply just after their release on the market to reach a plateau over time, between 56% and 72% of the total prescription per year in PE patients (p for trend = 0.33). Active malignancy and renal function impairment were factors independently associated with non-prescription of DOACs. Overall, prescription of DOACs was appropriate in 95.3% of patients. The rate of use of non-recommended DOAC doses was 4.2% (n = 28). The rate of death, recurrent VTE, bleeding and CTEPH were 2.4%, 1.2%, 7.2%, and 1.9%, respectively in the DOAC group.
Conclusion: The choice to prescribe DOACs or not is related to patient characteristics. The overall appropriateness of prescription is high, while the rate of adverse events observed in patients treated with DOAC is low in our registry.
(Copyright © 2018 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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