Scientific Poster Session I - Residents and Fellows Research-in-Progress

Residents and Fellows Research in Progress
  Saturday, October 12, 2024
  11:30 AM–01:00 PM

Abstract

Introduction:

Landmark venous thromboembolism (VTE) trials for apixaban and rivaroxaban utilized lead-in doses prior to maintenance dosing due to the heightened risk of recurrence in the initial management phase. While many patients in these trials received parenteral anticoagulation prior to the first lead-in dose, it is unclear whether a full lead-in duration is needed after receiving more than 48 hours of parenteral anticoagulation. A few studies have identified patient characteristics that may play a role in a provider’s decision to modify the lead-in period based on the receipt of parenteral anticoagulation. It remains uncertain whether shortening the lead-in period impacts patient outcomes such as VTE recurrence and bleeding events.

Research Question or Hypothesis:

This project aims to characterize DOAC prescribing practices, identify potential reasons for opting out of a full lead-in duration, and assess clinical outcomes for patients with acute VTE who have received parenteral anticoagulation for at least 24 hours.

Study Design:

Retrospective, single-center, cohort study at a large academic medical center in Roanoke, Virginia.

Methods:

Adult patients admitted between January 1, 2022 and December 31, 2023 with newly diagnosed acute VTE started on apixaban or rivaroxaban following at least 24 hours of parenteral anticoagulation were included. Patients were excluded for prior to admission anticoagulation, inappropriate maintenance dose or extended lead-in duration, and administration of vitamin K antagonists. Full versus reduced lead-in were compared with a primary outcome of hours of parenteral anticoagulation prior to first DOAC dose. Secondary outcomes included days between diagnosis and first DOAC dose, number of DOAC lead-in doses, and total duration of parenteral anticoagulation plus DOAC lead-in. VTE recurrence and bleeding events within 90 days were used as efficacy and safety endpoints, respectively. Chi-square and Mann-Whitney U tests were used to compare non-parametric nominal and continuous variables, respectively, with a p-value = 0.05 considered statistically significant.

Results:

Results to follow.

Conclusion:

Conclusion to follow.

Presenting Author

Kaley Hart PharmD
Carilion Clinic

Authors

Tamara Davidson Pharm.D., BCPS
Megan Rhoten PharmD, BCPS, BCCP
Carilion Clinic

Jennifer Wright PharmD, BCPS