title: Rivaroxaban for the treatment of venous thromboembolism. The SWIss Venous ThromboEmbolism Registry (SWIVTER).
abstract: We investigated three-month clinical outcomes in patients with venous thromboembolism (VTE) treated with rivaroxaban or conventional anticoagulation in routine clinical practice. Between November 2012 and February 2015, 2,062 consecutive patients with VTE from 11 acute care hospitals in Switzerland were enrolled in the SWIss Venous ThromboEmbolism Registry (SWIVTER). Overall, 417 (20 %) patients were treated with rivaroxaban. In comparison to 1,645 patients on conventional anticoagulation, patients on rivaroxaban were younger (56 ± 18 vs. 65 ± 17 years; p<0.001), less often had pulmonary embolism (38 % vs 66 %; p<0.001), hypertension (26 % vs 41 %; p<0.001), cancer (10 % vs 28 %; p<0.001), congestive heart failure (10 % vs 17 %; p=0.001), diabetes (8 % vs 15 %; p<0.001), chronic lung disease (7 % vs 13 %; p=0.001), renal insufficiency (7 % vs 13 %; p=0.001), recent surgery (7 % vs 14 %; p<0.001), and acute coronary syndrome (1 % vs 4 %; p=0.009). VTE reperfusion therapy was more frequently used (28 % vs 9 %; p<0.001) and indefinite-duration anticoagulation treatment less often planned (26 % vs 39 %; p<0.001), respectively. In the propensity score-adjusted population, the risk of recurrent VTE was similar in patients on rivaroxaban vs conventional anticoagulation (1.2 % vs 2.1 %, hazard ratio [HR] 0.55, 95 % confidence interval [CI] 0.18-1.65; p=0.29); the risk of major bleeding was also similar, respectively (0.5 % vs 0.5 %, HR 1.00, 95 %CI 0.14-7.07; p=1.00). Conventional anticoagulation is still frequently used for the treatment of VTE, particularly in the elderly and those with comorbidities. Early clinical outcomes were comparable between propensity score-adjusted patient populations on rivaroxaban and conventional anticoagulation.
authors.affiliation: Nils Kucher, MD, Division of Vascular Medicine, Swiss Cardiovascular Center, Bern University Hospital, 3010 Bern, Switzerland, Tel.: +41 31 632 7963, Fax: +41 31 632 4380, E-mail: nils.kucher@insel.ch.
authors.forename: Nils
authors.initials: N
authors.lastname: Kucher
authors.forename: Drahomir
authors.initials: D
authors.lastname: Aujesky
authors.forename: Jürg H
authors.initials: JH
authors.lastname: Beer
authors.forename: Lucia
authors.initials: L
authors.lastname: Mazzolai
authors.forename: Thomas
authors.initials: T
authors.lastname: Baldi
authors.forename: Martin
authors.initials: M
authors.lastname: Banyai
authors.forename: Daniel
authors.initials: D
authors.lastname: Hayoz
authors.forename: Thomas
authors.initials: T
authors.lastname: Kaeslin
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Korte
authors.forename: Robert
authors.initials: R
authors.lastname: Escher
authors.forename: Marc
authors.initials: M
authors.lastname: Husmann
authors.forename: Beat
authors.initials: B
authors.lastname: Frauchiger
authors.forename: Iris
authors.initials: I
authors.lastname: Baumgartner
authors.forename: David
authors.initials: D
authors.lastname: Spirk
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D065427:Factor Xa Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000188:drug therapy; D012042:Registries; D012189:Retrospective Studies; D000069552:Rivaroxaban / Q000009:adverse effects / Q000627:therapeutic use*; D013557:Switzerland; D015912:Thrombolytic Therapy; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000188:drug therapy*
chemical_list: D000925:Anticoagulants; D065427:Factor Xa Inhibitors; D000069552:Rivaroxaban
keywords: Anticoagulation; rivaroxaban; venous thromboembolism