Effectiveness of Oral Xa Inhibitors vs. Warfarin in the Prevention of Recurrent Deep Vein Thrombosis, Pulmonary Embolism, and Incidence of Post-Thrombotic Syndrome Following Intervention for First-Time Proximal AcuteIliofemoral, Femoropopliteal, or Popliteal Thrombosis: A Retrospective Chart Review

Abstract

BACKGROUND: Anticoagulation is the treatment of deep vein thrombosis (DVT) and prevents thrombus extension and recurrence of DVT. There is limited data on the effectiveness of Oral Xa inhibitors versus Warfarin in the prevention of recurrent DVT, pulmonary embolism (PE), and post-thrombotic syndrome (PTS), specifically in patients who receive intervention for a first-time acute proximal DVT. OBJECTIVES: Add to the literature regarding the effectiveness of Xa inhibitors and Warfarin in the prevention of recurrent DVT, PE, and PTS following a first-time proximal DVT. PATIENTS/METHODS: Retrospective chart review of 35 patients following a first time proximal acute thrombosis and begun on Xa inhibitor or Warfarin as anti-coagulation therapy. Data from 2010 through 2019, with an age range of 18-95, including all genders and ethnicities. Any patients with symptomatic peripheral arterial disease, chronic inflammatory disease, active cancer, history of DVT, inferior vena cava involvement, or with active pregnancy were excluded from the study. A Wilcoxon Rank sum was used to compare continuous variables, and a Chi Squared/Fischer’s Exact method was used to compare categorical variables. RESULTS AND CONCLUSIONS: 18.7% of patients undergoing Warfarin treatment suffered a DVT recurrence by 12 months, while 84.2% of patients undergoing Oral Xa treatment suffered a DVT recurrence by 12 months, a significant difference (p < 0.001). No other outcomes showed a significant difference. This study is limited by a small number of subjects, and lack of standardization across several of the outcome variables. Further research needs to be conducted to clarify the objective of this study.