In which cases would you consider early transition to DOAC (within 72 hours) for hospitalized patients with intermediate or high risk PE?
Assume thrombolytics are not indicated. Do you favor early DOAC transition after 24-48 hours of heparin gtt or do you favor LMWH for 10-14 days followed by DOAC?
2 Answers
Mednet Member
Pulmonology · Washington State University Floyd College of Medicine
Answered on
Two DOACs are FDA-approved for early use (within 72 hrs), rivaroxaban and apixaban. The PEITHO-2 dabigatran cohort study included no comparison group (its authors called it a "trial"?) and required "72 hrs" parenteral anticoagulant before dabigatran but the small print in its Lancet Haematology show...
Join for free or sign in to see the full answer
Mednet MemberInvited Expert
Hematology · University of Maryland
Answered on
The PEITHO-2 trial of early (after 72 hours) switch to oral anticoagulation in patients with acute intermediate-risk pulmonary embolism showed that the primary outcome of recurrent symptomatic venous thromboembolism within 6 months only occurred in patients with intermediate-high risk (3% of the pop...
Join for free or sign in to see the full answer