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Ramos-Isaza E, Tuta-Quintero E, Bastidas-Goyes A, Diaz-Quijano D, Aponte-Murcia C, Espitia-Angel J, Pinto-Beltran D, Rincón-Hernández J, Sánchez-Cuellar J, Pérez-Bueno J, Giraldo-Cadavid LF. Long-term survival in venous thromboembolic disease: rivaroxaban vs. warfarin - propensity score matching study. BMC Pharmacol Toxicol 2023; 24:77. [PMID: 38093310 PMCID: PMC10720047 DOI: 10.1186/s40360-023-00712-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 11/22/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Venous thromboembolic disease (VTE) is characterized by obstruction of venous blood flow by a thrombus. Survival data, frequency of disease recurrence, and bleeding rate in patients on anticoagulant therapy with warfarin compared to rivaroxaban in the Latin American population are limited in VTE. METHODS A retrospective cohort study with propensity score matching analysis was conducted in patients with pulmonary embolism and/or deep vein thrombosis anticoagulated with warfarin or rivaroxaban treated. Survival analysis was performed using a Kaplan-Meier curve for each of the intervention groups, and it was compared using a Log Rank test. RESULTS Of 2193 potentially eligible patients with a suspected diagnosis of VTE, 505 patients entered the analysis; of these, 285 subjects were managed with warfarin and 220 anticoagulated with rivaroxaban. Major bleeding at 12 months occurred in 2.7% (6/220) of patients treated with Rivaroxaban, compared to 10.2% (29/285) in the Warfarin group in the unmatched population (p = 0.001). In the matched population, bleeding at 12 months occurred in 2.9% (6/209) of patients on Rivaroxaban and in 11.0% (23/209) of patients on Warfarin (p = 0.001). The survival rates at 6 months were 97.1% for Rivaroxaban and 97.6% for Warfarin (p = 0.76). At 12 months, the survival rates were 94.7% for Rivaroxaban and 95.7% for Warfarin (p = 0.61). CONCLUSION In the treatment of VTE, there is no differences on 6 and 12-month survival or a reduction in the occurrence of new thromboembolic events when comparing rivaroxaban to warfarin. However, a lower risk of major bleeding is observed at 12 months with Rivaroxaban.
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Affiliation(s)
- Estefan Ramos-Isaza
- Medicine at Facultad de Medicina, Universidad de La Sabana, Universidad de La Sabana, Km 7, Autonorte de Bogota, Chía, Cundinamarca, 250001, Colombia
| | - Eduardo Tuta-Quintero
- Medicine at Facultad de Medicina, Universidad de La Sabana, Universidad de La Sabana, Km 7, Autonorte de Bogota, Chía, Cundinamarca, 250001, Colombia
| | - Alirio Bastidas-Goyes
- Medicine at Facultad de Medicina, Universidad de La Sabana, Universidad de La Sabana, Km 7, Autonorte de Bogota, Chía, Cundinamarca, 250001, Colombia.
| | - Diana Diaz-Quijano
- Medicine at Facultad de Medicina, Universidad de La Sabana, Universidad de La Sabana, Km 7, Autonorte de Bogota, Chía, Cundinamarca, 250001, Colombia
| | | | - Julian Espitia-Angel
- Medicine at Facultad de Medicina, Universidad de La Sabana, Universidad de La Sabana, Km 7, Autonorte de Bogota, Chía, Cundinamarca, 250001, Colombia
| | - Daniel Pinto-Beltran
- Medicine at Facultad de Medicina, Universidad de La Sabana, Universidad de La Sabana, Km 7, Autonorte de Bogota, Chía, Cundinamarca, 250001, Colombia
| | - Johan Rincón-Hernández
- Medicine at Facultad de Medicina, Universidad de La Sabana, Universidad de La Sabana, Km 7, Autonorte de Bogota, Chía, Cundinamarca, 250001, Colombia
| | - Juan Sánchez-Cuellar
- Medicine at Facultad de Medicina, Universidad de La Sabana, Universidad de La Sabana, Km 7, Autonorte de Bogota, Chía, Cundinamarca, 250001, Colombia
| | - Jesus Pérez-Bueno
- Medicine at Facultad de Medicina, Universidad de La Sabana, Universidad de La Sabana, Km 7, Autonorte de Bogota, Chía, Cundinamarca, 250001, Colombia
| | - Luis F Giraldo-Cadavid
- Medicine at Facultad de Medicina, Universidad de La Sabana, Universidad de La Sabana, Km 7, Autonorte de Bogota, Chía, Cundinamarca, 250001, Colombia
- Chief of the Interventional Pulmonology Service, Facultad de Medicina, Fundacion Neumologica Colombiana, Universidad de La Sabana, Bogotá, Colombia
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