Predictors of use of direct oral anticoagulants in patients with venous thromboembolism: Findings from the Registro Informatizado Enfermedad Tromboembólica registry.
Autor: | Lorenzo A; Department of Internal Medicine, Hospital Universitario La Paz, Madrid, Spain., Beroiz P; Department of Geriatrics, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain.; Department of Medicine, Universidad Autónoma de Barcelona, Barcelona, Spain., Ortiz S; Department of Applied Economics, Universidad Autónoma Madrid, S&H Medical Science Service Advisor, Madrid, Spain., Del Toro J; Department of Internal Medicine, Hospital General Universitario Gregorio Marañón, Madrid, Spain., Mazzolai L; Department of Angiology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland., Bura-Riviere A; Department of Vascular Medicine, Hôpital de Rangueil, Toulouse, France., Visonà A; Department of Vascular Medicine, Ospedale Castelfranco Veneto, Castelfranco Veneto, Italy., Verhamme P; Vascular Medicine and Haemostasis, University of Leuven, Leuven, Belgium., Di Micco P; Department of Internal Medicine and Emergency Room, Ospedale Buon Consiglio Fatebenefratelli, Naples, Italy., Camporese G; Angiology Unit, Department of Cardiac, Thoracic and Vascular Sciences, Padua University Hospital, Padua, Italy., Sancho Bueso T; Department of Internal Medicine, Hospital Universitario La Paz, Madrid, Spain., Monreal M; Department of Internal Medicine, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain.; Chair for the Study of Thromboembolic Disease, Faculty of Health Sciences, UCAM-Universidad Católica San Antonio de Murcia, Murcia, Spain. |
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Jazyk: | angličtina |
Zdroj: | Frontiers in medicine [Front Med (Lausanne)] 2022 Nov 25; Vol. 9, pp. 991376. Date of Electronic Publication: 2022 Nov 25 (Print Publication: 2022). |
DOI: | 10.3389/fmed.2022.991376 |
Abstrakt: | Background: Current guidelines recommend the use of direct oral anticoagulants (DOACs) for patients with venous thromboembolism (VTE). However little is known about the use of DOACs in daily practice. Methods: We used the RIETE registry to identify predictors of use of DOACs for initial and/or long-term therapy of VTE based on patient-related factors, institution-related factors or over time. Results: Among 41,678 patients from March 2013 to September 2021, 12,286 (29%) used DOACs: for initial therapy 6,456; for long-term therapy 12,046. On multivariable analysis, independent predictors were: age < 65 years (odds ratio [OR]: 1.30; 95% CI: 1.23-1.38), body weight <50 kg (OR: 0.54; 95% CI: 0.45-0.65) or >120 kg (OR: 0.64; 95% CI: 0.53-0.77), initial VTE presentation as pulmonary embolism (OR: 1.18; 95% CI: 1.13-1.25), recent bleeding (OR: 0.53; 95% CI: 0.45-0.63), renal insufficiency (OR: 0.44; 95% CI: 0.38-0.51), liver cirrhosis (OR: 0.32; 95% CI: 0.20-0.52), thrombocytopenia (OR: 0.40; 95% CI: 0.34-0.49), atrial fibrillation (OR: 1.58; 95% CI: 1.42-1.75) and prior VTE (OR: 1.14; 95% CI: 1.06-1.22). The DOACs were more likely used in other European countries (OR: 8.97; 95% CI: 8.49-9.49), America (OR: 6.35; 95% CI: 5.67-7.11) or in other countries of the world (OR: 2.99; 95% CI: 2.70-3.31) than in Spain, and progressively increased from 2013-2015 to 2016-2018 (OR: 2.78; 95% CI: 2.62-2.95) and 2019-2021 (OR: 6.36; 95% CI: 5.95-6.80). Conclusion: In this large multinational VTE registry, variations were observed in the use of DOACs according to patient or country factors, and over time. The safety, costs, and influence of the DOACs on VTE-related outcomes in daily practice warrant further investigation. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2022 Lorenzo, Beroiz, Ortiz, del Toro, Mazzolai, Bura-Riviere, Visonà, Verhamme, Di Micco, Camporese, Sancho Bueso, Monreal and the RIETE Investigators.) |
Databáze: | MEDLINE |
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