Pulmonary vascular disease & thromboembolismResearch article
Oral Anticoagulants and Risk of Bleeding and Death in Cancer-Associated Venous Thromboembolism
- Cox regression analysis of U.S. Medicare 20% sample databases
Authors' conclusion
Among patients with Ca-VTE, apixaban may be associated with lower risk of hospitalized bleeding than rivaroxaban. Additional research is needed to understand associations of OAC prescribed with all-cause mortality among patients with Ca-VTE.
Study context
- Population
- Patients with cancer-associated VTE (Ca-VTE) aged ≥65 years who filled prescriptions for oral anticoagulant (OACs), U.S. Medicare 20% sample databases, 2011 to 2019patients with Ca-VTE who filled prescriptions for OACs · apixaban 6,546 · rivaroxaban 7,936 · warfarin 15,860
- Participants
- 30,342 patients
- Comparison
- Risks of hospitalized bleeding and death by oral anticoagulant (OAC) prescribed (ie, apixaban, rivaroxaban, and warfarin), overall and by cancer site
- apixabann = 6,546
- rivaroxabann = 7,936reference
- warfarinn = 15,860
Main finding
As reported in the abstract
Incident hospitalized bleeding and death (all patients) · within 6 months of incident venous thromboembolism
Experienced incident hospitalized bleeding
634
Died
5,977
Further findings
| Outcome | HR | |
|---|---|---|
| Hospitalized bleeding · 6 months · overall | 0.68 (95% CI 0.56–0.83) | |
| Mortality · 6 months · no association overall | 0.99 (CI 0.91–1.08) | |
| 0.512Hazard ratio (log scale) |
Hospitalized bleeding · 6 months
- This pattern was present for most cancer sites (ie, breast, colon, lung, and prostate), though precision was poor and associations were not statistically significant
- No clear pattern emerged when comparing apixaban or rivaroxaban to warfarin
Stratified analyses by age category, sex, prevalent kidney disease status, and metastatic cancer status
- Results were generally similar
Original publication
Oral Anticoagulants and Risk of Bleeding and Death in Cancer-Associated Venous Thromboembolism. JACC Adv. doi:10.1016/j.jacadv.2026.102777
Summarised from the published abstract; every number is checked against it