Rivaroxaban for Thromboprophylaxis in Acutely Ill Medical Patients

In acutely ill patients, 10 days of rivaroxaban was noninferior to 10 days of enoxaparin for thromboprophylaxis. Extended-duration rivaroxaban treatment (35 days) reduced the risk of venous thromboembolism. Rivaroxaban was associated with an increased risk of bleeding. Patients with active cancer, s...

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Bibliographic Details
Published in:The New England journal of medicine Vol. 368; no. 6; pp. 513 - 523
Main Authors: Cohen, Alexander T, Spiro, Theodore E, Büller, Harry R, Haskell, Lloyd, Hu, Dayi, Hull, Russell, Mebazaa, Alexandre, Merli, Geno, Schellong, Sebastian, Spyropoulos, Alex C, Tapson, Victor
Format: Journal Article
Language:English
Published: Waltham, MA Massachusetts Medical Society 07.02.2013
Subjects:
Acute Disease
Administration, Oral
Adult
Aged
Anticoagulants
Anticoagulants - adverse effects
Anticoagulants - therapeutic use
Asymptomatic
Biological and medical sciences
Double-Blind Method
Drug Administration Schedule
Enoxaparin
Enoxaparin - adverse effects
Enoxaparin - therapeutic use
Factor Xa
Factor Xa Inhibitors
Female
General aspects
Heart attacks
Hemorrhage
Hemorrhage - chemically induced
Hospitalization
Humans
Injections, Subcutaneous
Life Sciences
Male
Medical sciences
Middle Aged
Morpholines
Morpholines - adverse effects
Morpholines - therapeutic use
Prevention and actions
Public health. Hygiene
Public health. Hygiene-occupational medicine
Pulmonary embolisms
Rivaroxaban
Thiophenes
Thiophenes - adverse effects
Thiophenes - therapeutic use
Thromboembolism
Thrombosis
Ultrasonic imaging
Veins & arteries
Venous Thromboembolism
Venous Thromboembolism - epidemiology
Venous Thromboembolism - prevention & control
Vascular disease
Human
Medicine
Prevention
Rivaroxaban
Antithrombotic agent
Cardiovascular disease
Patient
Thrombosis
ISSN:0028-4793, 1533-4406, 1533-4406
Online Access:Get full text
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Summary:In acutely ill patients, 10 days of rivaroxaban was noninferior to 10 days of enoxaparin for thromboprophylaxis. Extended-duration rivaroxaban treatment (35 days) reduced the risk of venous thromboembolism. Rivaroxaban was associated with an increased risk of bleeding. Patients with active cancer, stroke, myocardial infarction, or acute exacerbations of a variety of medical conditions are at increased risk for venous thromboembolism. 1 Prolonged immobilization and risk factors such as an age older than 75 years, chronic heart failure, a history of venous thromboembolism, and obesity can increase this risk further. 2 , 3 Randomized, controlled trials involving hospitalized patients at increased risk for venous thromboembolism have shown the benefits of administering anticoagulant agents for up to 14 days, 4 – 8 and guidelines recommend the use of unfractionated heparin, low-molecular-weight heparins, or fondaparinux in such patients. 9 There is some evidence that the risk . . .
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ISSN:0028-4793
1533-4406
1533-4406
DOI:10.1056/NEJMoa1111096