Apixaban or Rivaroxaban Versus Warfarin for Treatment of Submassive Pulmonary Embolism After Catheter-Directed Thrombolysis. (September 2018)

• Record Type: Journal Article
• Authors: Groetzinger, Lara M.; Miller, Taylor J.; Rivosecchi, Ryan M.; Smith, Roy E.; Gladwin, Mark T.; Rivera-Lebron, Belinda N.
• Is Part Of: Clinical and applied thrombosis/hemostasis. Volume 24:Number 6(2018)
• Page Start: 908
• Page End: 913
• Publication Date: 2018-09
• Subjects: anticoagulants -- pulmonary embolism -- catheter-directed thrombolysis -- factor Xa inhibitors; Hemostasis -- Periodicals; Thrombosis -- Periodicals; 616.13
• DOI: 10.1177/1076029618755311
• Languages: English
• ISSNs: 1076-0296

Abstract

Background: Little data exist on the use of direct oral anticoagulant (DOAC) factor Xa inhibitors for submassive pulmonary embolism (PE) after catheter-directed thrombolysis (CDT). The objective of this evaluation was to determine whether the transition from parenteral anticoagulation to DOACs for submassive PE after CDT would decrease hospital length of stay (LOS) compared to warfarin. Methods: A retrospective review of patients diagnosed with submassive PE who underwent CDT was conducted from January 1, 2012, to February 28, 2017. Hospital LOS and major and minor bleeding events were recorded during hospitalization and at 90 days. Results: Sixty-two patients met the inclusion criteria, 36 in warfarin group and 26 in the DOAC group. Overall, patients receiving rivaroxaban or apixaban had a shorter median hospital LOS compared to warfarin (4.0 vs 6.1 days, P = .002). In the multivariate regression analysis, administration of DOAC was an independent predictor of decreased hospital LOS, β: −2.1, 95% confidence interval (−3.5 to −0.7). Conclusion: Among patients with submassive PE, initiation of a DOAC shortly after CDT may result in a decreased hospital LOS compared to parenterally bridged warfarin.