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Effectiveness and safety of oral anticoagulation treatment beyond 1 year after venous thromboembolism in patients at intermediate recurrence risk.
Johnsen, Søren P; Rasmussen, Thomas B; Falstie-Jensen, Anne Mette; Harboe, Louise; Stynes, Gillian; Dybro, Lars; Hansen, Morten L; Brandes, Axel; Grove, Erik L; Münster, Anna-Marie.
Afiliación
  • Johnsen SP; Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
  • Rasmussen TB; Danish Center for Clinical Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
  • Falstie-Jensen AM; Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
  • Harboe L; Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
  • Stynes G; Bristol Myers Squibb, Copenhagen, Denmark.
  • Dybro L; Worldwide Value, Access and Pricing & HEOR, Bristol Myers Squibb, Lawrenceville, New Jersey, USA.
  • Hansen ML; Internal medicine, Pfizer Pharmaceutical Group, Pfizer, Copenhagen, Denmark.
  • Brandes A; Department of Cardiology, Gentofte Hospital, Copenhagen, Denmark.
  • Grove EL; Department of Cardiology, Odense University Hospital, Odense, Denmark.
  • Münster AM; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
Basic Clin Pharmacol Toxicol ; 129(3): 210-220, 2021 Sep.
Article en En | MEDLINE | ID: mdl-34128322
Effectiveness and safety of long-term anticoagulation treatment are uncertain in venous thromboembolism (VTE) patients at intermediate risk of recurrence. We examined the association between treatment beyond 1 year and outcomes in a Danish nationwide register-based study. VTE patients at intermediate risk of recurrence, that is, non-cancer patients with a first-time unprovoked VTE, who started oral anticoagulation treatment within 30 days and were alive 365 days after the index VTE were included and followed between 2007 and 2015. Exposure was extended (>365 days) or intermediate (91-365 days) treatment. Analyses were done using Cox regression on a propensity score weighted population. We included 18 609 patients with 7232 (38.9%) receiving extended treatment. Mean duration of follow-up was 2.6 years. Compared with intermediate treatment, treatment beyond 365 days was associated with a lower weighted risk of recurrent VTE (hazard ratio [HR] 0.56, 95% confidence interval [CI] 0.49-0.65) and all-cause mortality (HR 0.81, 95% CI 0.72-0.90) and an increased risk of major bleeding (HR 1.87, 95% CI 1.58-2.22). In conclusion, extended anticoagulation treatment (predominantly warfarin) beyond 1 year was in real-life settings associated with a lower risk of recurrent VTE and all-cause mortality among VTE patients with an intermediate risk of recurrence. However, an increased bleeding risk should be considered.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tromboembolia Venosa / Hemorragia / Anticoagulantes Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Basic Clin Pharmacol Toxicol Asunto de la revista: FARMACOLOGIA / TOXICOLOGIA Año: 2021 Tipo del documento: Article País de afiliación: Dinamarca Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tromboembolia Venosa / Hemorragia / Anticoagulantes Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Basic Clin Pharmacol Toxicol Asunto de la revista: FARMACOLOGIA / TOXICOLOGIA Año: 2021 Tipo del documento: Article País de afiliación: Dinamarca Pais de publicación: Reino Unido