■缺乏在住院癌症患者中使用直接口服抗凝剂(DOAC)预防静脉血栓栓塞(VTE)的研究。因此,我们进行了一项多中心回顾性队列研究,以评估DOACs与低分子肝素(LMWH)在住院癌症患者VTE一级预防中的有效性和安全性.
■临床结果包括血栓形成,VTE,其他血栓形成,所有出血,大出血,非大出血,和全因死亡。通过倾向评分匹配创建利伐沙班和LMWH患者的1:1队列。
■本研究共纳入2,385名癌症患者。在3个月的随访期间,发生129例(5.4%)血栓事件,其中63例(2.7%)为VTE,其中66例(2.8%)为其他血栓形成事件。所有出血均发生在163例(6.8%)患者中,68(2.9%)有大出血,95例(4.0%)有非大出血.全因死亡病例113例(4.7%)。在调整了各种混杂因素后,利伐沙班组血栓形成和其他血栓形成的发生率明显低于低分子肝素组[OR0.543,95%CI(0.343-0.859),p=0.009;OR0.461,95%CI(0.241-0.883),p=0.020]。VTE发生率差异无统计学意义,总出血,大出血,非大出血,或全因死亡。
■在接受血栓预防的肿瘤患者中,利伐沙班的血栓形成和其他血栓形成的发生率较低,VTE的发生率与LMWH相似,并且不会增加出血风险.利伐沙班可能是LMWH预防住院癌症患者VTE的有吸引力的替代品。
UNASSIGNED: Studies on the use of direct oral anticoagulants (DOACs) for preventing venous thromboembolism (VTE) in hospitalized cancer patients are lacking. Therefore, we conducted a multicenter retrospective cohort
study to evaluate the efficacy and safety of DOACs versus low-molecular-weight heparin (LMWH) for the primary prevention of VTE in hospitalized cancer patients.
UNASSIGNED: Clinical outcomes included thrombosis, VTE, other thrombosis, all bleeding, major bleeding, nonmajor bleeding, and all-cause death. A 1:1 cohort of rivaroxaban and LMWH patients was created by propensity score matching.
UNASSIGNED: A total of 2,385 cancer patients were included in this
study. During the 3-month follow-up period, 129 (5.4%) thrombosis events occurred, 63 (2.7%) of which were VTEs and 66 (2.8%) of which were other thrombosis events. All bleeding occurred in 163 (6.8%) patients, 68 (2.9%) had major bleeding, and 95 (4.0%) had nonmajor bleeding. All-cause deaths occurred in 113 (4.7%) patients. After adjusting for various confounders, the incidence of thrombosis and other thromboses was significantly lower in the rivaroxaban group than in the LMWH group [OR 0.543, 95% CI (0.343-0.859), p = 0.009; OR 0.461, 95% CI (0.241-0.883), p = 0.020]. There were no significant differences in incidence of VTE, total bleeding, major bleeding, nonmajor bleeding, or all-cause death.
UNASSIGNED: In oncology patients receiving thromboprophylaxis, rivaroxaban has a lower incidence of thrombosis and other thrombosis and a similar incidence of VTE as LMWH and does not increase the risk of bleeding. Rivaroxaban may be an attractive alternative to LMWH for preventing VTE in hospitalized cancer patients.