Predictors of use of direct oral anticoagulants in patients with venous thromboembolism : Findings from the Registro Informatizado Enfermedad Tromboembólica registry
Lorenzo, Alicia (Hospital Universitario La Paz (Madrid))
Beroiz, Patricia (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Ortiz, Salvador (Universidad Autónoma de Madrid)
Del Toro, Jorge (Hospital General Universitario Gregorio Marañón)
Mazzolai, Lucia (Centre Hospitalier Universitaire Vaudois (CHUV))
Bura-Riviere, Alessandra (Hôpital de Rangueil)
Visonà, Adriana (Ospedale Castelfranco Veneto)
Verhamme, Peter (University of Leuven)
Di Micco, Pierpaolo (Ospedale Buon Consiglio Fatebenefratelli)
Camporese, Giuseppe (University Hospital of Padova (Pàdua, Itàlia))
Sancho Bueso, Teresa (Hospital Universitario La Paz (Madrid))
Monreal, Manuel (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Universitat Autònoma de Barcelona

Date:	2022
Abstract:	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. 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. 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). 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.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Anticoagulant therapy ; Different countries ; Direct oral anticoagulants ; Predictors ; RIETE ; Venous thromboembolism
Published in:	Frontiers in Medicine, Vol. 9 (november 2022) , ISSN 2296-858X

DOI: 10.3389/fmed.2022.991376
PMID: 36507510

11 p, 375.1 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Articles > Research articles
Articles > Published articles