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Treatment of Atrial Fibrillation and Venous Thromboembolism with Factor Xa Inhibitors in Severely Obese Patients.
Dobry, Paul; Edwin, Stephanie B; Haymart, Brian; Barnes, Geoffrey D; Kaatz, Scott; Ali, Mona A; Giuliano, Christopher.
Afiliación
  • Dobry P; Department of Pharmacy, Ascension St. John Hospital; Department of Pharmacy Practice, Wayne State University. Electronic address: paul.dobry@ascension.org.
  • Edwin SB; Department of Pharmacy, Ascension St. John Hospital.
  • Haymart B; Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan.
  • Barnes GD; Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan.
  • Kaatz S; Division of Hospital Medicine, Henry Ford Health, Detroit, MI, USA.
  • Ali MA; Department of Heart and Vascular Services, Corewell Health William Beaumont University Hospital.
  • Giuliano C; Department of Pharmacy, Ascension St. John Hospital; Department of Pharmacy Practice, Wayne State University.
J Thromb Haemost ; 2024 Sep 05.
Article en En | MEDLINE | ID: mdl-39243861
ABSTRACT

BACKGROUND:

A paucity of data exists to support the use of factor Xa inhibitors in severely obese patients with a weight ≥ 150kg or BMI ≥ 50 kg/m2.

OBJECTIVES:

The purpose of this study is to evaluate whether factor Xa inhibitors are as safe and effective as warfarin for the treatment of atrial fibrillation (AF) and/or venous thromboembolism (VTE) in individuals with a BMI ≥ 50 kg/m2 and/or weight ≥ 150 kg. PATIENTS /

METHODS:

This was a multicenter retrospective cohort study of severely obese adult patients with AF and/or VTE treated with a factor Xa inhibitor or warfarin. The primary effectiveness outcome was a composite odds of stroke, systemic embolism or VTE; the primary safety outcome was odds of major bleeding. Secondary outcomes included incidence of stroke or systemic embolism, VTE, major bleeding, clinically relevant non-major bleeding, all-cause mortality, change in anticoagulation and total number of hospital encounters. Outcomes were assessed for 12 months following initiation of study drug.

RESULTS:

A total of 1,736 patients were included. The mean weight and BMI of the overall cohort was 164.4 kg and 54.6 kg/m2, respectively. There was no difference in odds of stroke, systemic embolism or VTE (OR 1.005, 95% CI 0.6 - 1.68) or major bleeding (OR 0.9, 95% CI 0.47 - 1.7) between groups.

CONCLUSIONS:

These data suggest that apixaban and rivaroxaban are safe and effective alternatives to warfarin for the treatment of AF and/or VTE in individuals with a BMI ≥ 50 kg/m2 and/or weight ≥ 150 kg.
Palabras clave

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Thromb Haemost Asunto de la revista: HEMATOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Thromb Haemost Asunto de la revista: HEMATOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido