タカダ　タクマ   TAKADA Takuma   髙田　卓磨    所属   研究施設 研究施設    職種   助教
言語種別	日本語
発表タイトル	Patient Characteristics and Clinical Outcomes among Direct Oral Anticoagulants for Cancer-Associated Venous Thromboembolism: From the COMMAND VTE Registry-2
会議名	第87回日本循環器学会学術集会
学会区分	全国規模の学会
発表形式	口頭
講演区分	一般
発表者・共同発表者	末田 大輔, 金田 和久, 西川 隆介, 茶谷 龍己, 西本 裕二, 池田 長生, 小林 洋平, 池田 聡司, 金 基泰, 髙瀬 徹, 辻 修平, 大井 磨紀, 高田 卓磨, 乙井 一典, 坂本 二郎, 荻原 義人, 辻田 賢一, 山下 侑吾
発表年月日	2023/03/12
開催地 （都市, 国名）	福岡
概要	Background: There is a paucity of data on patient characteristics and clinical outcomes among direct oral anticoagulants (DOACs) for cancer-associated venous thromboembolism (VTE). Methods: The COMMAND VTE Registry-2 is a multicenter registry enrolling 5,197 consecutive acute symptomatic VTE patients among 31 centers in Japan between January 2015 and August 2020. The current study population consisted of 1,197 patients with active cancer, who were divided into edoxaban (N=643, 54%), rivaroxaban (N=297, 25%), and apixaban (N=257, 21%) group. Results: Pulmonary embolism was more frequent in rivaroxaban and apixaban group (edoxaban 45% vs. rivaroxaban 57% vs. apixaban 59%, P*0.001). Chronic kidney disease trended to be least frequent in rivaroxaban group, although not significant (19% vs. 13% vs. 17%, P=0.10, respectively). Anemia was least frequent in rivaroxaban group (78% vs. 69% vs. 75%, P=0.01, respectively). Continuous intravenous injection of heparin was least frequent in rivaroxaban group (43% vs. 32% vs. 37%, P*0.001, respectively). The 3-year cumulative discontinuation rates of DOACs were lowest in rivaroxaban group (66.5% vs. 57.6% vs. 60.7%, P=0.04, respectively). The 3-year cumulative incidence rates of recurrent VTE and all-cause death were not significantly different among the groups (recurrent VTE: 7.9% vs. 7.4% vs. 6.6%, P=0.82, respectively; all-cause death: 58.8% vs. 56.4% vs. 52.4%, P=0.22, respectively). Whereas, the 3-year cumulative incidence rates of major bleeding were significantly lower in rivaroxaban group (17.6% vs. 10.4% vs. 16.1%, P=0.04, respectively). Conclusions: Patient characteristics was somewhat different according to different DOACs, and there was not significant difference in the risk of recurrent VTE nor all-cause death although there could be some difference for bleeding risk.