Department of Angiology, Clinic for Heart, Blood Vessel and Rheumatic Diseases, Clinical Centre University of Sarajevo, Sarajevo, Bosnia and Herzegovina
,
Department of Cardiology, General Hospital “Prim.dr Abdulah Nakaš“, Sarajevo, Bosnia and Herzegovina
Department of Pharmacology, School of Medicine, Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina
Department of Science, School of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
Department of Pharmacology, School of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
Department of Physiology, School of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
Clinic for Infectious Diseases, Clinical Centre University of Sarajevo, Sarajevo, Bosnia and Herzegovina
Emergency Medicine Department of Canton Sarajevo, Sarajevo, Bosnia and Herzegovina
Aim
To evaluate the efficacy (rate of recanalization) of therapy with novel oral anticoagulants (NOAC; rivaroxaban, apixaban)
compared to conventional treatment (low molecular weight heparin - LMWH and vitamin K antagonist) in the treatment of deep vein thrombosis (DVT) of the proximal segments of lower extremities.
Methods
The first group consisted of patients diagnosed with DVT and treated with NOAC (n = 100), while the second group consisted of patients diagnosed with DVT, who were treated by conventional treatment (low molecular weight heparin and vitamin K antagonists) (n = 100). In the first group, NOAC was included in the initial treatment. Patients in the second group were treated with LMWH for four days, and on the fifth day vitamin K antagonist was included in therapy, international ratio (INR) was titrated to therapeutic values (2.0-3.0), and then low molecular weight heparin was excluded from the therapy.
Results
There was a statistically significant difference in the estimated values of free lumen of the blood vessel between the examined groups after 30 days (p=0.0001), after 90 days (p=0.0001) and after 180 days (p=0.0001). After 180 days, the average free lumen values in the NOAC group were 85% (81-89%), which was significantly higher than the free lumen values in the second group, 73% (69-79%).
Conclusion
The use of NOAC represents more efficient treatment of DVT comparing to vitamin K antagonists.
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