Author + information
Background: Although medically ill patients remain at elevated risk for venous thromboembolism (VTE) after hospital discharge, there is no approved anticoagulant for extended duration use and guidelines recommend against post-hospitalization thromboprophylaxis. The Acute Medically Ill VTE Prevention with Extended Duration Betrixaban (APEX) trial evaluated the safety and efficacy of extended thromboprophylaxis with betrixaban vs standard duration parenteral enoxaparin.
Objectives and Methods: The incidence of symptomatic VTE (composite of symptomatic deep vein thrombosis, non-fatal pulmonary embolism, or VTE related mortality) was evaluated in a landmark analysis following discontinuation of active parenteral therapy in the enoxaparin arm vs discontinuation of placebo parenteral therapy in the betrixaban arm. Following discontinuation of enoxaparin parenteral therapy, active betrixaban was compared to placebo betrixaban in the enoxaparin arm.
Results: During the parenteral therapy period, VTE did not differ between betrixaban vs enoxaparin [HR 0.79 (95% CI 0.30-2.13), p=0.64]. Following discontinuation of parenteral therapy, betrixaban reduced VTE [HR 0.61 (95% CI 0.38-0.99), p=0.041]. (Figure).
Conclusions: Extended duration betrixaban beyond the usual period of parenteral prophylaxis with enoxaparin reduced VTE among medically ill patients.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Diabetes and Other Issues in Cardiovascular Prevention
Abstract Category: 32. Prevention: Clinical
Presentation Number: 1277-055
- 2017 American College of Cardiology Foundation