Predictors of use of direct oral anticoagulants in patients with venous thromboembolism: Findings from the Registro Informatizado Enfermedad Tromboembólica registry
BackgroundCurrent guidelines recommend the use of direct oral anticoagulants (DOACs) for patients with venous thromboembolism (VTE). However little is known about the use of DOACs in daily practice.MethodsWe used the RIETE registry to identify predictors of use of DOACs for initial and/or long-term...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-11-01
|
| Series: | Frontiers in Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2022.991376/full |
| _version_ | 1828119498632200192 |
|---|---|
| author | Alicia Lorenzo Patricia Beroiz Patricia Beroiz Salvador Ortiz Jorge del Toro Lucia Mazzolai Alessandra Bura-Riviere Adriana Visonà Peter Verhamme Pierpaolo Di Micco Giuseppe Camporese Teresa Sancho Bueso Manuel Monreal Manuel Monreal the RIETE Investigators |
| author_facet | Alicia Lorenzo Patricia Beroiz Patricia Beroiz Salvador Ortiz Jorge del Toro Lucia Mazzolai Alessandra Bura-Riviere Adriana Visonà Peter Verhamme Pierpaolo Di Micco Giuseppe Camporese Teresa Sancho Bueso Manuel Monreal Manuel Monreal the RIETE Investigators |
| author_sort | Alicia Lorenzo |
| collection | DOAJ |
| description | BackgroundCurrent guidelines recommend the use of direct oral anticoagulants (DOACs) for patients with venous thromboembolism (VTE). However little is known about the use of DOACs in daily practice.MethodsWe used the RIETE registry to identify predictors of use of DOACs for initial and/or long-term therapy of VTE based on patient-related factors, institution-related factors or over time.ResultsAmong 41,678 patients from March 2013 to September 2021, 12,286 (29%) used DOACs: for initial therapy 6,456; for long-term therapy 12,046. On multivariable analysis, independent predictors were: age < 65 years (odds ratio [OR]: 1.30; 95% CI: 1.23–1.38), body weight <50 kg (OR: 0.54; 95% CI: 0.45–0.65) or >120 kg (OR: 0.64; 95% CI: 0.53–0.77), initial VTE presentation as pulmonary embolism (OR: 1.18; 95% CI: 1.13–1.25), recent bleeding (OR: 0.53; 95% CI: 0.45–0.63), renal insufficiency (OR: 0.44; 95% CI: 0.38–0.51), liver cirrhosis (OR: 0.32; 95% CI: 0.20–0.52), thrombocytopenia (OR: 0.40; 95% CI: 0.34–0.49), atrial fibrillation (OR: 1.58; 95% CI: 1.42–1.75) and prior VTE (OR: 1.14; 95% CI: 1.06–1.22). The DOACs were more likely used in other European countries (OR: 8.97; 95% CI: 8.49–9.49), America (OR: 6.35; 95% CI: 5.67–7.11) or in other countries of the world (OR: 2.99; 95% CI: 2.70–3.31) than in Spain, and progressively increased from 2013–2015 to 2016–2018 (OR: 2.78; 95% CI: 2.62–2.95) and 2019–2021 (OR: 6.36; 95% CI: 5.95–6.80).ConclusionIn this large multinational VTE registry, variations were observed in the use of DOACs according to patient or country factors, and over time. The safety, costs, and influence of the DOACs on VTE-related outcomes in daily practice warrant further investigation. |
| first_indexed | 2024-04-11T13:49:48Z |
| format | Article |
| id | doaj.art-503704dd0433413aa731f1e45069d323 |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-04-11T13:49:48Z |
| publishDate | 2022-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-503704dd0433413aa731f1e45069d3232022-12-22T04:20:43ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-11-01910.3389/fmed.2022.991376991376Predictors of use of direct oral anticoagulants in patients with venous thromboembolism: Findings from the Registro Informatizado Enfermedad Tromboembólica registryAlicia Lorenzo0Patricia Beroiz1Patricia Beroiz2Salvador Ortiz3Jorge del Toro4Lucia Mazzolai5Alessandra Bura-Riviere6Adriana Visonà7Peter Verhamme8Pierpaolo Di Micco9Giuseppe Camporese10Teresa Sancho Bueso11Manuel Monreal12Manuel Monreal13the RIETE InvestigatorsDepartment of Internal Medicine, Hospital Universitario La Paz, Madrid, SpainDepartment of Geriatrics, Hospital Germans Trias i Pujol, Badalona, Barcelona, SpainDepartment of Medicine, Universidad Autónoma de Barcelona, Barcelona, SpainDepartment of Applied Economics, Universidad Autónoma Madrid, S&H Medical Science Service Advisor, Madrid, SpainDepartment of Internal Medicine, Hospital General Universitario Gregorio Marañón, Madrid, SpainDepartment of Angiology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, SwitzerlandDepartment of Vascular Medicine, Hôpital de Rangueil, Toulouse, FranceDepartment of Vascular Medicine, Ospedale Castelfranco Veneto, Castelfranco Veneto, ItalyVascular Medicine and Haemostasis, University of Leuven, Leuven, Belgium0Department of Internal Medicine and Emergency Room, Ospedale Buon Consiglio Fatebenefratelli, Naples, Italy1Angiology Unit, Department of Cardiac, Thoracic and Vascular Sciences, Padua University Hospital, Padua, ItalyDepartment of Internal Medicine, Hospital Universitario La Paz, Madrid, Spain2Department of Internal Medicine, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain3Chair for the Study of Thromboembolic Disease, Faculty of Health Sciences, UCAM—Universidad Católica San Antonio de Murcia, Murcia, SpainBackgroundCurrent guidelines recommend the use of direct oral anticoagulants (DOACs) for patients with venous thromboembolism (VTE). However little is known about the use of DOACs in daily practice.MethodsWe used the RIETE registry to identify predictors of use of DOACs for initial and/or long-term therapy of VTE based on patient-related factors, institution-related factors or over time.ResultsAmong 41,678 patients from March 2013 to September 2021, 12,286 (29%) used DOACs: for initial therapy 6,456; for long-term therapy 12,046. On multivariable analysis, independent predictors were: age < 65 years (odds ratio [OR]: 1.30; 95% CI: 1.23–1.38), body weight <50 kg (OR: 0.54; 95% CI: 0.45–0.65) or >120 kg (OR: 0.64; 95% CI: 0.53–0.77), initial VTE presentation as pulmonary embolism (OR: 1.18; 95% CI: 1.13–1.25), recent bleeding (OR: 0.53; 95% CI: 0.45–0.63), renal insufficiency (OR: 0.44; 95% CI: 0.38–0.51), liver cirrhosis (OR: 0.32; 95% CI: 0.20–0.52), thrombocytopenia (OR: 0.40; 95% CI: 0.34–0.49), atrial fibrillation (OR: 1.58; 95% CI: 1.42–1.75) and prior VTE (OR: 1.14; 95% CI: 1.06–1.22). The DOACs were more likely used in other European countries (OR: 8.97; 95% CI: 8.49–9.49), America (OR: 6.35; 95% CI: 5.67–7.11) or in other countries of the world (OR: 2.99; 95% CI: 2.70–3.31) than in Spain, and progressively increased from 2013–2015 to 2016–2018 (OR: 2.78; 95% CI: 2.62–2.95) and 2019–2021 (OR: 6.36; 95% CI: 5.95–6.80).ConclusionIn this large multinational VTE registry, variations were observed in the use of DOACs according to patient or country factors, and over time. The safety, costs, and influence of the DOACs on VTE-related outcomes in daily practice warrant further investigation.https://www.frontiersin.org/articles/10.3389/fmed.2022.991376/fullvenous thromboembolismdirect oral anticoagulantsanticoagulant therapypredictorsRIETEdifferent countries |
| spellingShingle | Alicia Lorenzo Patricia Beroiz Patricia Beroiz Salvador Ortiz Jorge del Toro Lucia Mazzolai Alessandra Bura-Riviere Adriana Visonà Peter Verhamme Pierpaolo Di Micco Giuseppe Camporese Teresa Sancho Bueso Manuel Monreal Manuel Monreal the RIETE Investigators Predictors of use of direct oral anticoagulants in patients with venous thromboembolism: Findings from the Registro Informatizado Enfermedad Tromboembólica registry Frontiers in Medicine venous thromboembolism direct oral anticoagulants anticoagulant therapy predictors RIETE different countries |
| title | Predictors of use of direct oral anticoagulants in patients with venous thromboembolism: Findings from the Registro Informatizado Enfermedad Tromboembólica registry |
| title_full | Predictors of use of direct oral anticoagulants in patients with venous thromboembolism: Findings from the Registro Informatizado Enfermedad Tromboembólica registry |
| title_fullStr | Predictors of use of direct oral anticoagulants in patients with venous thromboembolism: Findings from the Registro Informatizado Enfermedad Tromboembólica registry |
| title_full_unstemmed | Predictors of use of direct oral anticoagulants in patients with venous thromboembolism: Findings from the Registro Informatizado Enfermedad Tromboembólica registry |
| title_short | Predictors of use of direct oral anticoagulants in patients with venous thromboembolism: Findings from the Registro Informatizado Enfermedad Tromboembólica registry |
| title_sort | predictors of use of direct oral anticoagulants in patients with venous thromboembolism findings from the registro informatizado enfermedad tromboembolica registry |
| topic | venous thromboembolism direct oral anticoagulants anticoagulant therapy predictors RIETE different countries |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2022.991376/full |
| work_keys_str_mv | AT alicialorenzo predictorsofuseofdirectoralanticoagulantsinpatientswithvenousthromboembolismfindingsfromtheregistroinformatizadoenfermedadtromboembolicaregistry AT patriciaberoiz predictorsofuseofdirectoralanticoagulantsinpatientswithvenousthromboembolismfindingsfromtheregistroinformatizadoenfermedadtromboembolicaregistry AT patriciaberoiz predictorsofuseofdirectoralanticoagulantsinpatientswithvenousthromboembolismfindingsfromtheregistroinformatizadoenfermedadtromboembolicaregistry AT salvadorortiz predictorsofuseofdirectoralanticoagulantsinpatientswithvenousthromboembolismfindingsfromtheregistroinformatizadoenfermedadtromboembolicaregistry AT jorgedeltoro predictorsofuseofdirectoralanticoagulantsinpatientswithvenousthromboembolismfindingsfromtheregistroinformatizadoenfermedadtromboembolicaregistry AT luciamazzolai predictorsofuseofdirectoralanticoagulantsinpatientswithvenousthromboembolismfindingsfromtheregistroinformatizadoenfermedadtromboembolicaregistry AT alessandraburariviere predictorsofuseofdirectoralanticoagulantsinpatientswithvenousthromboembolismfindingsfromtheregistroinformatizadoenfermedadtromboembolicaregistry AT adrianavisona predictorsofuseofdirectoralanticoagulantsinpatientswithvenousthromboembolismfindingsfromtheregistroinformatizadoenfermedadtromboembolicaregistry AT peterverhamme predictorsofuseofdirectoralanticoagulantsinpatientswithvenousthromboembolismfindingsfromtheregistroinformatizadoenfermedadtromboembolicaregistry AT pierpaolodimicco predictorsofuseofdirectoralanticoagulantsinpatientswithvenousthromboembolismfindingsfromtheregistroinformatizadoenfermedadtromboembolicaregistry AT giuseppecamporese predictorsofuseofdirectoralanticoagulantsinpatientswithvenousthromboembolismfindingsfromtheregistroinformatizadoenfermedadtromboembolicaregistry AT teresasanchobueso predictorsofuseofdirectoralanticoagulantsinpatientswithvenousthromboembolismfindingsfromtheregistroinformatizadoenfermedadtromboembolicaregistry AT manuelmonreal predictorsofuseofdirectoralanticoagulantsinpatientswithvenousthromboembolismfindingsfromtheregistroinformatizadoenfermedadtromboembolicaregistry AT manuelmonreal predictorsofuseofdirectoralanticoagulantsinpatientswithvenousthromboembolismfindingsfromtheregistroinformatizadoenfermedadtromboembolicaregistry AT therieteinvestigators predictorsofuseofdirectoralanticoagulantsinpatientswithvenousthromboembolismfindingsfromtheregistroinformatizadoenfermedadtromboembolicaregistry |