RSS-Feed abonnieren
DOI: 10.1055/a-1926-2489
Extended Thromboprophylaxis in Hospitalized Patients with Heart Failure: A Post Hoc Analysis of the MAGELLAN Study
Funding Medical writing support was provided by Oghenetega Umukoro, PhD, of Lumanity Communications Inc. (Yardley, PA, USA), which was funded by Janssen Scientific Affairs, LLC (Titusville, NJ, USA).
Abstract
This post hoc subgroup analysis examined efficacy and safety outcomes with extended thromboprophylaxis rivaroxaban compared with in-hospital enoxaparin in 2,078 patients from the MAGELLAN study who had a hospitalization for heart failure or a history of heart failure and a lower risk of bleeding. A significant 36% reduction in the composite endpoint of asymptomatic proximal deep vein thrombosis (DVT) in the lower extremity, symptomatic DVT in the lower extremity (proximal or distal), symptomatic nonfatal pulmonary embolism, and venous thromboembolism-related death was observed with rivaroxaban. Major bleeding was low in both groups and not significantly increased with rivaroxaban.
Keywords
heart failure - thrombosis - rivaroxaban - direct oral anticoagulants - venous thromboembolism - medically illAuthors' Contributions
All authors participated in the design and analytical approach of the study and contributed to the manuscript development. Results were summarized and interpreted in collaboration with all authors. Authors vouch for the accuracy and completeness of the data reported and the adherence of the study to the protocol. All authors gave final approval of the version to be published.
Publikationsverlauf
Eingereicht: 17. Juni 2022
Angenommen: 15. August 2022
Accepted Manuscript online:
17. August 2022
Artikel online veröffentlicht:
07. Oktober 2022
© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References
- 1 Lip GY, Gibbs CR. Does heart failure confer a hypercoagulable state? Virchow's triad revisited. J Am Coll Cardiol 1999; 33 (05) 1424-1426
- 2 Alikhan R, Spyropoulos AC. Epidemiology of venous thromboembolism in cardiorespiratory and infectious disease. Am J Med 2008; 121 (11) 935-942
- 3 Witt BJ, Gami AS, Ballman KV. et al. The incidence of ischemic stroke in chronic heart failure: a meta-analysis. J Card Fail 2007; 13 (06) 489-496
- 4 Spyropoulos AC, Hussein M, Lin J, Battleman D. Rates of venous thromboembolism occurrence in medical patients among the insured population. Thromb Haemost 2009; 102 (05) 951-957
- 5 Virani SS, Alonso A, Aparicio HJ. et al; American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics-2021 update: a report from the American Heart Association. Circulation 2021; 143 (08) e254-e743
- 6 Heit JA, Spencer FA, White RH. The epidemiology of venous thromboembolism. J Thromb Thrombolysis 2016; 41 (01) 3-14
- 7 Mebazaa A, Spiro TE, Büller HR. et al. Predicting the risk of venous thromboembolism in patients hospitalized with heart failure. Circulation 2014; 130 (05) 410-418
- 8 Spencer FA, Lessard D, Emery C, Reed G, Goldberg RJ. Venous thromboembolism in the outpatient setting. Arch Intern Med 2007; 167 (14) 1471-1475
- 9 Schünemann HJ, Cushman M, Burnett AE. et al. American Society of Hematology 2018 guidelines for management of venous thromboembolism: prophylaxis for hospitalized and nonhospitalized medical patients. Blood Adv 2018; 2 (22) 3198-3225
- 10 Johnson & Johnson. U.S. FDA approves XARELTO ® (rivaroxaban) to help prevent blood clots in acutely ill medical patients; 2019. Accessed 16 September 2022 at: https://www.jnj.com/u-s-fda-approves-xarelto-rivaroxaban-to-help-prevent-blood-clots-in-acutely-ill-medical-patients#:~:text=RARITAN%2C%20N.J.%2C%20October%2014%2C,medical%20patients%20at%20risk%20for
- 11 Cohen AT, Spiro TE, Büller HR. et al; MAGELLAN Investigators. Rivaroxaban for thromboprophylaxis in acutely ill medical patients. N Engl J Med 2013; 368 (06) 513-523
- 12 Spyropoulos AC, Cohen AT, Lipardi C. et al. Abstract 10541: improved benefit risk profile of rivaroxaban in a MARINER-like subpopulation of the MAGELLAN study. Circulation 2018; 138 (Suppl. 01) A10541
- 13 Spyropoulos AC, Lipardi C, Xu J. et al. Improved benefit risk profile of rivaroxaban in a subpopulation of the MAGELLAN study. Clin Appl Thromb Hemost 2019; 25: 1076029619886022
- 14 Spyropoulos AC, Raskob GE, Cohen AT. et al. Association of bleeding severity with mortality in extended thromboprophylaxis of medically ill patients in the MAGELLAN and MARINER Trials. Circulation 2022; 145 (19) 1471-1479