Effect of different initial anticoagulant strategies on short-term outcome of patients with symptomatic DVT in China

Int J Clin Pract. 2021 Oct;75(10):e14619. doi: 10.1111/ijcp.14619. Epub 2021 Aug 8.

Abstract

Purpose: In ambulant patients with lower limb DVT managed with Warfarin, there is a need for initial treatment and short time "bridging" with a rapidly acting anticoagulant until there is a stable therapeutic INR. In this study, results from bridging with subcutaneous low molecular weight heparin (LMWH) or oral Rivaroxaban were compared.

Methods: One hundred and twenty-four patients received LMWH and 98 patients received Rivaroxaban, both in addition to Warfarin. Patients were assessed at 1 and 4 weeks after treatment initiation for thrombus progression, bleeding, clinic attendance and INR.

Findings: The treatment groups were well matched. There were no significant differences between the treatment groups for any of the end-points at either 1 week or 4 weeks.

Implications: In ambulant patients with DVT treated with Warfarin both Rivaroxaban and LMWH are suitable for use in the early phase of Warfarin treatment until therapeutic INR is achieved. Rivaroxaban is a suitable alternative to LMWH for patients who prefer not to have injections.

MeSH terms

  • Anticoagulants* / therapeutic use
  • Heparin, Low-Molecular-Weight / therapeutic use
  • Humans
  • Rivaroxaban / therapeutic use
  • Venous Thrombosis* / drug therapy
  • Warfarin / therapeutic use

Substances

  • Anticoagulants
  • Heparin, Low-Molecular-Weight
  • Warfarin
  • Rivaroxaban