Chia Nan University of Pharmacy & Science Institutional Repository:Item 310902800/34647
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    標題: Recurrent thromboembolism, bleeding, and mortality in Asian patients with venous thromboembolism receiving different oral anticoagulants: A nationwide analysis
    作者: Lee, Mei-Chuan
    Liao, Chia-Te
    Feng, I-Jung
    Yu, Tsung
    Chang, Wei-Ting
    Shih, Mei-Fen
    Su, Hui-Chen
    Toh, Han Siong
    貢獻者: Chi Mei Hospital
    National Cheng Kung University
    Chi Mei Hospital
    Southern Taiwan University of Science & Technology
    National Sun Yat Sen University
    National Cheng Kung University
    Southern Taiwan University of Science & Technology
    Chia Nan University of Pharmacy & Science
    Chi Mei Hospital
    Chia Nan University of Pharmacy & Science
    關鍵字: rivaroxaban
    risk
    population
    warfarin
    prevention
    dabigatran
    quality
    safety
    日期: 2022
    上傳時間: 2023-12-11 14:02:32 (UTC+8)
    出版者: LIPPINCOTT WILLIAMS & WILKINS
    摘要: Venous thromboembolism (VTE) is associated with a high risk of morbidity and mortality. However, data on the association between oral anticoagulants and the hazards of VTE complications in Taiwanese patients with VTE is limited. This study aimed to compare the hazards of recurrent VTE, bleeding, and mortality between patients with VTE receiving rivaroxaban, a non-vitamin K antagonist oral anticoagulant (NOAC), and those receiving heparin or low-molecular-weight heparin (LMWH) followed by warfarin. Patients with VTE treated with rivaroxaban, or heparin or LMWH followed by warfarin were enrolled from 2 million random samples from Taiwan's National Health Insurance database between 2013 and 2016. Hazards of recurrent VTE (deep vein thrombosis and pulmonary embolism), major bleeding, and mortality in rivaroxaban and warfarin users were investigated. Survival analyses were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Users of rivaroxaban (183) and warfarin (456) were included in the study. Patients receiving rivaroxaban did not have significantly lower hazards of developing recurrent VTE (HR, 0.72 [CI, 0.37-1.37], P = .31) and mortality (HR, 0.86 [CI, 0.49-1.50], P = .59) than those receiving heparin or LMWH followed by warfarin. In addition, the hazard ratio of major bleeding was not significantly different between the 2 regimens (HR, 1.80 [CI, 0.39-8.29], P = .45). Rivaroxaban was not associated with lower risks of recurrent VTE and mortality and higher hazards of major bleeding than heparin or LMWH followed by warfarin in Taiwanese patients with VTE. Clinicians may tailor oral anticoagulants for VTE patients according to the patient's characteristics, cost-effectiveness and healthcare system policy.
    關聯: MEDICINE, v.101, n.CB2, pp.CC2, pp.-,
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