PMID- 33391553
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210105
IS  - 1881-641X (Print)
IS  - 1881-6428 (Electronic)
IS  - 1881-641X (Linking)
VI  - 13
IP  - 4
DP  - 2020 Dec 25
TI  - Administration of Direct Oral Anticoagulant Immediately after Unfractionated 
      Heparin Bolus for the Treatment of Intermediate-High-Risk Pulmonary 
      Thromboembolism.
PG  - 370-376
LID - 10.3400/avd.oa.20-00079 [doi]
AB  - Objective: This study aims to evaluate the efficacy and safety of direct oral 
      anticoagulants (DOACs) after unfractionated heparin (UFH) bolus for the treatment 
      of intermediate-high-risk pulmonary embolism. Materials and Methods: On the basis 
      of initial treatment, 81 patients were divided into two groups: DOAC after UFH 
      bolus infusion group (group D; n=32) and conventional therapy group (group C; 
      n=49). The frequency of recurrence of venous thromboembolism (VTE) and bleeding 
      within 6 months were compared. In addition, hospitalization length and thrombus 
      reduction rate in the pulmonary artery on computed tomography (CT) at the chronic 
      phase were assessed. Results: Recurrence of VTE was found in one (3.1%) and three 
      patients (6.1%) (P=1.00) in groups D and C, respectively, whereas no bleeding 
      events was found in group D and 8.2% of patients in group C (P=0.15). Group D 
      showed shorter hospitalization (7.2+/-2.3 days) than group C (15.7+/-9.9 days; 
      P<0.001). In the subset of patients with serial CT assessment (group D, n=20; 
      group C, n=38), almost all thrombus of pulmonary artery were disappeared and the 
      thrombus reduction rates were similar between the two groups (group D, 99.5%; 
      group C, 97.1%; P=0.59). Conclusion: DOAC administration immediately after UFH 
      bolus treatment has the same efficacy and safety, whereas hospitalization days 
      were significantly shorter than the conventional treatment group.
CI  - (c) 2020 The Editorial Committee of Annals of Vascular Diseases.
FAU - Hara, Nobuhiro
AU  - Hara N
AD  - Department of Cardiology, Japanese Red Cross Musashino Hospital, Tokyo, Japan.
FAU - Watanabe, Keita
AU  - Watanabe K
AD  - Department of Cardiology, Japanese Red Cross Musashino Hospital, Tokyo, Japan.
FAU - Miyazaki, Ryoichi
AU  - Miyazaki R
AD  - Department of Cardiology, Japanese Red Cross Musashino Hospital, Tokyo, Japan.
FAU - Nakamura, Tomofumi
AU  - Nakamura T
AD  - Department of Cardiology, Japanese Red Cross Musashino Hospital, Tokyo, Japan.
FAU - Lee, Tetsumin
AU  - Lee T
AD  - Department of Cardiology, Japanese Red Cross Musashino Hospital, Tokyo, Japan.
FAU - Nagata, Yasutoshi
AU  - Nagata Y
AD  - Department of Cardiology, Japanese Red Cross Musashino Hospital, Tokyo, Japan.
FAU - Nozato, Toshihiro
AU  - Nozato T
AD  - Department of Cardiology, Japanese Red Cross Musashino Hospital, Tokyo, Japan.
FAU - Miyamoto, Takamichi
AU  - Miyamoto T
AD  - Department of Cardiology, Japanese Red Cross Musashino Hospital, Tokyo, Japan.
FAU - Obayashi, Toru
AU  - Obayashi T
AD  - Department of Cardiology, Japanese Red Cross Musashino Hospital, Tokyo, Japan.
AD  - Department of Clinical Engineering, Gunma Paz College, Takasaki, Gunma, Japan.
FAU - Ashikaga, Takashi
AU  - Ashikaga T
AD  - Department of Cardiology, Japanese Red Cross Musashino Hospital, Tokyo, Japan.
LA  - eng
PT  - Journal Article
PL  - Japan
TA  - Ann Vasc Dis
JT  - Annals of vascular diseases
JID - 101471467
PMC - PMC7758599
OTO - NOTNLM
OT  - anticoagulation
OT  - direct oral anticoagulant
OT  - intermediate-high-risk pulmonary embolism
OT  - therapy
COIS- Disclosure StatementThe authors declare that there is no conflict of interest.
EDAT- 2021/01/05 06:00
MHDA- 2021/01/05 06:01
PMCR- 2020/12/25
CRDT- 2021/01/04 05:28
PHST- 2021/01/04 05:28 [entrez]
PHST- 2021/01/05 06:00 [pubmed]
PHST- 2021/01/05 06:01 [medline]
PHST- 2020/12/25 00:00 [pmc-release]
AID - 10.3400/avd.oa.20-00079 [doi]
PST - ppublish
SO  - Ann Vasc Dis. 2020 Dec 25;13(4):370-376. doi: 10.3400/avd.oa.20-00079.