L Jeraj1, M K Jezovnik2, P Poredos3. 1. Department of vascular disease, University Medical Centre Ljubljana, Slovenia. 2. University of Texas, Health Science Center at Houston, Houston, TX, USA. 3. Department of vascular disease, University Medical Centre Ljubljana, Slovenia. Electronic address: pavel.poredos@kclj.si.
Abstract
INTRODUCTION: Post-thrombotic syndrome (PTS) is a chronic complication of deep vein thrombosis (DVT) that affects 20% to 50% of DVT patients. Standard DVT treatment included vitamin K antagonists (usually warfarin) with low-molecular-weight heparin in the initial period. In recent years, direct oral anticoagulants (DOAC) were introduced. We aimed to investigate the influence of rivaroxaban and warfarin on PTS development. METHODS: Consecutive patients treated for DVT were included, 39 were treated with warfarin and 61 with rivaroxaban. We assessed symptoms and signs of PTS and calculated Villalta score 23months (median) after acute DVT diagnosis. Differences between patients treated with rivaroxaban and warfarin were investigated. RESULTS: Patients in the rivaroxaban group had a lower prevalence of PTS than those treated with warfarin (25% vs. 49%, p=0.013). Logistic regression showed odds ratio of 2.9 (1.2-6.8, p=0.014) for PTS development in warfarin group compared to rivaroxaban group. When adjusted for other variables, the odds ratio was 3.5 (1.1-11.0, p=0.035). CONCLUSIONS: Treatment of DVT with rivaroxaban might be associated with a lower risk for PTS development. A larger randomized trial would be needed for stronger evidence.
INTRODUCTION: Post-thrombotic syndrome (PTS) is a chronic complication of deep vein thrombosis (DVT) that affects 20% to 50% of DVT patients. Standard DVT treatment included vitamin K antagonists (usually warfarin) with low-molecular-weight heparin in the initial period. In recent years, direct oral anticoagulants (DOAC) were introduced. We aimed to investigate the influence of rivaroxaban and warfarin on PTS development. METHODS: Consecutive patients treated for DVT were included, 39 were treated with warfarin and 61 with rivaroxaban. We assessed symptoms and signs of PTS and calculated Villalta score 23months (median) after acute DVT diagnosis. Differences between patients treated with rivaroxaban and warfarin were investigated. RESULTS:Patients in the rivaroxaban group had a lower prevalence of PTS than those treated with warfarin (25% vs. 49%, p=0.013). Logistic regression showed odds ratio of 2.9 (1.2-6.8, p=0.014) for PTS development in warfarin group compared to rivaroxaban group. When adjusted for other variables, the odds ratio was 3.5 (1.1-11.0, p=0.035). CONCLUSIONS: Treatment of DVT with rivaroxaban might be associated with a lower risk for PTS development. A larger randomized trial would be needed for stronger evidence.
Authors: Damon E Houghton; Alexander Lekah; Thanila A Macedo; David Hodge; Rayya A Saadiq; Yvonne Little; Ana I Casanegra; Robert D McBane; Waldemar E Wysokinski Journal: J Thromb Thrombolysis Date: 2020-02 Impact factor: 2.300
Authors: Ingrid M Bistervels; Roisin Bavalia; Jan Beyer-Westendorf; Arina J Ten Cate-Hoek; Sebastian M Schellong; Michael J Kovacs; Nicolas Falvo; Karina Meijer; Dominique Stephan; Wim G Boersma; Marije Ten Wolde; Francis Couturaud; Peter Verhamme; Dominique Brisot; Susan R Kahn; Waleed Ghanima; Karine Montaclair; Amanda Hugman; Patrick Carroll; Gilles Pernod; Olivier Sanchez; Emile Ferrari; Pierre-Marie Roy; Marie-Antoinette Sevestre-Pietri; Simone Birocchi; Hilde S Wik; Barbara A Hutten; Michiel Coppens; Christiane Naue; Michael A Grosso; Minggao Shi; Yong Lin; Isabelle Quéré; Saskia Middeldorp Journal: Res Pract Thromb Haemost Date: 2022-07-01