Rivaroxaban versus low-molecular-weight heparins for short- and long-term prognosis in patients with deep vein thrombosis after spontaneous intracranial hemorrhage
Aim: Anticoagulation is the cornerstone of deep vein thrombosis (DVT) treatment, but in patients with intracerebral hemorrhage, it requires a delicate balance between preventing thrombosis and minimizing the risk of rebleeding. To assess the effects of rivaroxaban on short- and long-term clinical...
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Becaris Publishing Limited
2025-01-01
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| Series: | Journal of Comparative Effectiveness Research |
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| author | Jingfan Li Qi Song Guannan Tong Chengyu Bian Huimei Zhang Hulin Zheng Yafei Wang |
| author_facet | Jingfan Li Qi Song Guannan Tong Chengyu Bian Huimei Zhang Hulin Zheng Yafei Wang |
| author_sort | Jingfan Li |
| collection | DOAJ |
| description | Aim: Anticoagulation is the cornerstone of deep vein thrombosis (DVT) treatment, but in patients with
intracerebral hemorrhage, it requires a delicate balance between preventing thrombosis and minimizing
the risk of rebleeding. To assess the effects of rivaroxaban on short- and long-term clinical prognosis in
patients with DVT who have suffered spontaneous intracranial hemorrhage (sICH). Materials & methods:
The study retrospectively enrolled 327 sICH patients with DVT from 11 October 2019 to 18 September
2023. The primary outcomes were defined as recurrent sICH, bleeding-related events and mortality within
90 days and 1 year. Multivariate logistic regression was conducted to evaluate the association between
rivaroxaban and clinical outcomes based on inverse probability of treatment weighting. Results: Of the
included patients, 230 received low-molecular-weight heparins (LMWH) and 97 received rivaroxaban.
The reoccurrence rate of sICH was 1.30 and 2.06% in the LMWH and rivaroxaban groups, respectively.
Bleeding rates were 8.70% in the LMWHgroup and 5.15% in the rivaroxaban group. The mortality was less
frequent in patients received rivaroxaban than LMWH, following up 90 days (8.25 vs 15.65%, p = 0.07) and
1 year (10.42 vs 25.22%, p = 0.003). Multivariate and inverse probability of treatment weighting-adjusted
analyses confirmed the association of rivaroxaban with reduced 1-year mortality and better functional
recovery. Conclusion: Rivaroxaban use in DVT patients after sICH was associated with lower long-term
mortality and better functional independence, without significantly increasing the risk of sICH recurrence
or bleeding complications. These findings should be interpreted with caution and require confirmation
through prospective randomized trials. |
| format | Article |
| id | doaj-art-6b0aeb2c239d4888b8a79e0d2b25d426 |
| institution | Kabale University |
| issn | 2042-6313 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Becaris Publishing Limited |
| record_format | Article |
| series | Journal of Comparative Effectiveness Research |
| spelling | doaj-art-6b0aeb2c239d4888b8a79e0d2b25d4262025-08-20T03:34:45ZengBecaris Publishing LimitedJournal of Comparative Effectiveness Research2042-63132025-01-0114810.57264/cer-2025-0030Rivaroxaban versus low-molecular-weight heparins for short- and long-term prognosis in patients with deep vein thrombosis after spontaneous intracranial hemorrhageJingfan Li0https://orcid.org/0009-0001-6201-6599Qi Song1https://orcid.org/0009-0008-9158-6815Guannan Tong2https://orcid.org/0009-0006-1882-4771Chengyu Bian3https://orcid.org/0009-0007-4139-9141Huimei Zhang4https://orcid.org/0009-0002-9220-8388Hulin Zheng5https://orcid.org/0009-0005-5988-3818Yafei Wang6https://orcid.org/0009-0009-6374-9450Department of Neurosurgery, The First Hospital of Yulin & The Second Affiliated Hospital, Yanan University, 719000, Shaanxi, ChinaDepartment of Neurosurgery, The First Hospital of Yulin & The Second Affiliated Hospital, Yanan University, 719000, Shaanxi, ChinaDepartment of Neurology, Xianyang Hospital of Yan’an University, Xianyang 712000, ChinaDepartment of Neurosurgery, The First Hospital of Yulin & The Second Affiliated Hospital, Yanan University, 719000, Shaanxi, ChinaDepartment of Neurosurgery, The First Hospital of Yulin & The Second Affiliated Hospital, Yanan University, 719000, Shaanxi, ChinaDepartment of Neurosurgery, The First Hospital of Yulin & The Second Affiliated Hospital, Yanan University, 719000, Shaanxi, ChinaDepartment of Neurosurgery, The First Hospital of Yulin & The Second Affiliated Hospital, Yanan University, 719000, Shaanxi, China; Institute of Health & Rehabilitation Science, School of Life Science & Technology, Xi’an Jiaotong University, Xi’an 710049, ChinaAim: Anticoagulation is the cornerstone of deep vein thrombosis (DVT) treatment, but in patients with intracerebral hemorrhage, it requires a delicate balance between preventing thrombosis and minimizing the risk of rebleeding. To assess the effects of rivaroxaban on short- and long-term clinical prognosis in patients with DVT who have suffered spontaneous intracranial hemorrhage (sICH). Materials & methods: The study retrospectively enrolled 327 sICH patients with DVT from 11 October 2019 to 18 September 2023. The primary outcomes were defined as recurrent sICH, bleeding-related events and mortality within 90 days and 1 year. Multivariate logistic regression was conducted to evaluate the association between rivaroxaban and clinical outcomes based on inverse probability of treatment weighting. Results: Of the included patients, 230 received low-molecular-weight heparins (LMWH) and 97 received rivaroxaban. The reoccurrence rate of sICH was 1.30 and 2.06% in the LMWH and rivaroxaban groups, respectively. Bleeding rates were 8.70% in the LMWHgroup and 5.15% in the rivaroxaban group. The mortality was less frequent in patients received rivaroxaban than LMWH, following up 90 days (8.25 vs 15.65%, p = 0.07) and 1 year (10.42 vs 25.22%, p = 0.003). Multivariate and inverse probability of treatment weighting-adjusted analyses confirmed the association of rivaroxaban with reduced 1-year mortality and better functional recovery. Conclusion: Rivaroxaban use in DVT patients after sICH was associated with lower long-term mortality and better functional independence, without significantly increasing the risk of sICH recurrence or bleeding complications. These findings should be interpreted with caution and require confirmation through prospective randomized trials.mortalityrivaroxabanspontaneous intracranial hemorrhagevenous thromboembolism |
| spellingShingle | Jingfan Li Qi Song Guannan Tong Chengyu Bian Huimei Zhang Hulin Zheng Yafei Wang Rivaroxaban versus low-molecular-weight heparins for short- and long-term prognosis in patients with deep vein thrombosis after spontaneous intracranial hemorrhage Journal of Comparative Effectiveness Research mortality rivaroxaban spontaneous intracranial hemorrhage venous thromboembolism |
| title | Rivaroxaban versus low-molecular-weight heparins for short- and long-term prognosis in patients with deep vein thrombosis after spontaneous intracranial hemorrhage |
| title_full | Rivaroxaban versus low-molecular-weight heparins for short- and long-term prognosis in patients with deep vein thrombosis after spontaneous intracranial hemorrhage |
| title_fullStr | Rivaroxaban versus low-molecular-weight heparins for short- and long-term prognosis in patients with deep vein thrombosis after spontaneous intracranial hemorrhage |
| title_full_unstemmed | Rivaroxaban versus low-molecular-weight heparins for short- and long-term prognosis in patients with deep vein thrombosis after spontaneous intracranial hemorrhage |
| title_short | Rivaroxaban versus low-molecular-weight heparins for short- and long-term prognosis in patients with deep vein thrombosis after spontaneous intracranial hemorrhage |
| title_sort | rivaroxaban versus low molecular weight heparins for short and long term prognosis in patients with deep vein thrombosis after spontaneous intracranial hemorrhage |
| topic | mortality rivaroxaban spontaneous intracranial hemorrhage venous thromboembolism |
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