Rivaroxaban treatment for young patients with pulmonary embolism (Review)

Trends in pulmonary embolism mortality rates by age group in the United States, 1999-2019

Introduction

Acute pulmonary embolism (PE) is a major cause of mortality in the United States. Recent reports indicate that PE-related mortality rates have increased among individuals younger than 65 years old. It remains unclear whether this increase in PE-related mortality is evenly distributed. A narrowly focused and clinically meaningful age group analysis is necessary.

Methods

Death certificate data from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database were examined to determine all-cause PE mortality trends from 1999 to 2019 among adults 25-39, 40-54, 55-69, 70-84, and ≥85 years old. The crude death rates for individual years and annual percentage change (APC) were calculated to determine trends.

Results

PE-related mortality rates increased among those 25-39, 40-54, and 55-69. Among individuals 25-39 years old, death rate increased from 1.8 to 2.0 (APC 0.7 [95% confidence interval (CI) 0.2 to 1.1]) between 1999 and 2014 and continued to increase from 2.0 to 2.4 (APC 4.1 [95% CI 1.8 to 6.5]) between 2014 and 2019. Among those 40-54 years old, the crude death rate increased from 5.7 to 7.5 (APC 2.0 [95% CI, 1.6 to 2.5]) between 2007 and 2019. Among those 55-69 years old the crude death rate increased from 15.6 to 18.5 (APC 2.2 [95% CI, 1.9 to 2.5]) between 2010 and 2019. Recent death rates decreased or plateaued among individuals older than 70.

Conclusions

Individuals younger than 70 years had increase in PE-related mortality between 1999 and 2019 with marked increase among those 25-39 years old.

Efficacy of rivaroxaban for the treatment of Chinese patients with acute pulmonary embolism: A retrospective study

Pulmonary embolism (PE) is a life-threatening disease, which accounts for the major type of venous thromboembolism. Currently, there is limited understanding and management for PE. Rivaroxaban is reported to treat patients with PE. However, there is still insufficient evidence on rivaroxaban for the treatment of Chinese patients with acute PE. Thus, this retrospective study investigated the benefits and safety of rivaroxaban for Chinese patients with acute PE.A total of 72 Chinese patient cases with acute PE were analyzed in this study. Of these, 36 cases who received rivaroxaban mono-therapy were assigned to the treatment group, while the remaining 36 cases who received standard therapy were assigned to the control group. The benefits were assessed by the duration of hospital stay, treatment satisfaction, and safety.After treatment, rivaroxaban mono-therapy showed better benefits in decreasing the duration of hospital stay (P < .01), increasing treatment satisfaction (P < .01), and reducing mild bleeding (P = .02) in Chinese patients with acute PE, than standard therapy.The results of this study indicated that rivaroxaban may provide more benefits than the standard therapy for Chinese patients with acute PE. Future studies are still needed to warrant the current results.