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Year: 2018

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Type: Article

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Title: Real-life Use of Anticoagulants in Venous Thromboembolism With a Focus on Patients With Exclusion Criteria for Direct Oral Anticoagulants

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Author: Moustafa, Farès
Author: Pesavento, Raffaele
Author: di Micco, Pierpaolo
Author: González-Martínez, José
Author: Quintavalla, Roberto
Author: Peris, Maria-Luisa
Author: Porras, José Antonio
Author: Falvo, Nicolas
Author: Baños, Pilar
Author: Monreal, Manuel
Author: Bosevski M
Author: Zdraveska M

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Abstract: We assessed the real-life use of direct oral anticoagulants (DOACs) in patients with venous thromboembolism (VTE) and exclusion criteria for randomized trials. From 2013 to 2016, 3,578 of 18,853 patients (19%) had exclusion criteria. Irrespective of which anticoagulant was chosen, they had more VTE recurrences (hazard ratio (HR): 3.10; 95% confidence interval (CI): 2.47-3.88), major bleeds (HR: 4.10; 95% CI: 3.38-4.96), and deaths (HR: 9.47; 95% CI: 8.46-10.6) than those without exclusion criteria. During initial therapy, no patient with exclusion criteria on DOACs (n = 115) recurred, but those on rivaroxaban bled less often (adjusted HR: 0.18; 95% CI: 0.04-0.79) than those on unfractionated heparin (n = 224) and similar to those (n = 3,172) on low-molecular-weight (LMWH) heparin. For long-term therapy, patients on rivaroxaban (n = 151) had nonsignificantly fewer VTE recurrences (adjusted HR: 0.74; 95% CI: 0.08-1.32) and major bleeds (adjusted HR: 0.41; 95% CI: 0.15-1.15) than those on LMWH (n = 2,071). The efficacy and safety of DOACs were similar to standard therapy.

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Publisher: Wiley

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Relation: Clinical Pharmacology & Therapeutics

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Identifier: oai:repository.ukim.mk:20.500.12188/29249
Identifier: http://hdl.handle.net/20.500.12188/29249
Identifier: 10.1002/cpt.781
Identifier: https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1002%2Fcpt.781
Identifier: https://onlinelibrary.wiley.com/doi/pdf/10.1002/cpt.781
Identifier: https://onlinelibrary.wiley.com/doi/full-xml/10.1002/cpt.781
Identifier: https://ascpt.onlinelibrary.wiley.com/doi/pdf/10.1002/cpt.781
Identifier: 103
Identifier: 4
Identifier: 684
Identifier: 691

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