Rivaroxaban versus warfarin in the prevention of post-thrombotic syndrome

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, dir...

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Bibliographic Details
Published in:Thrombosis research 2017-09, Vol.157, p.46-48
Main Authors: Jeraj, L, Jezovnik, M.K, Poredos, P
Format: Article
Language:English
Subjects:
Aged
Anticoagulants
Anticoagulants - pharmacology
Anticoagulants - therapeutic use
Direct oral anticoagulants
Factor Xa Inhibitors - pharmacology
Factor Xa Inhibitors - therapeutic use
Female
Hematology, Oncology and Palliative Medicine
Humans
Male
Middle Aged
Post-thrombotic syndrome
Postthrombotic Syndrome - diagnosis
Postthrombotic Syndrome - pathology
Postthrombotic Syndrome - prevention & control
Recanalization
Rivaroxaban - pharmacology
Rivaroxaban - therapeutic use
Venous thrombosis
Warfarin - pharmacology
Warfarin - therapeutic use
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Summary: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 23 months (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.
ISSN:0049-3848
1879-2472
DOI:10.1016/j.thromres.2017.05.029