Concomitant Antiplatelet Therapy in Patients With Venous Thromboembolism Treated With Anticoagulants ― Insights From the COMMAND VTE Registry-2 ―
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Direct oral anticoagulants (DOACs) are commonly used oral anticoagulants for patients with venous thromboembolism (VTE). Sometimes these patients receive concomitant antiplatelet therapy, with limited data supporting the practice. This study investigated the effect of concomitant antiplatelet therapy (CAT) on clinical outcomes in VTE patients treated with anticoagulants. METHODS AND RESULTS: The COMMAND VTE Registry-2 is a multicenter registry that enrolled 5,197 consecutive patients with acute symptomatic VTE across 31 centers in Japan between January 2015 and August 2020. After excluding 407 patients without oral anticoagulants, there were 4,790 VTE patients treated with oral anticoagulants. After propensity score matching, 676 patients (338 matched pairs in the CAT and anticoagulant only [AC] groups) were included for analysis. There were no significant differences between the CAT and AC groups in the cumulative 3-year incidence of recurrent VTE (4.9% vs. 7.3%, respectively; P=0.50), major bleeding (9.4% vs. 12.4%, respectively; P=0.36), or stroke (6.7% vs. 4.1%, respectively; P=0.24). However, the cumulative 3-year incidence of clinically relevant non-major bleeding (CRNMB) was significantly higher in the CAT group than in the AC group (17.7% vs. 10.0%; P=0.047). CONCLUSIONS: In a large VTE registry in the DOAC era, concomitant antiplatelet and anticoagulant therapy, compared with anticoagulant alone, was not significantly associated with risks of recurrent VTE, major bleeding, or stroke, but did increase the risk of CRNMB.
Source: Circulation Journal
Authors: Kazuhisa Kaneda, Yugo Yamashita, Takeshi Morimoto, Ryuki Chatani, Yuji Nishimoto, Nobutaka Ikeda, Yohei Kobayashi, Satoshi Ikeda, Kitae Kim, Moriaki Inoko, Toru Takase, Shuhei Tsuji, Maki Oi, Takuma Takada, Kazunori Otsui, Jiro Sakamoto, Yoshito Ogihara, Takeshi Inoue, Shunsuke Usami, Po-Min Chen, Kiyonori Togi, Norimichi Koitabashi, Seiichi Hiramori, Kosuke Doi, Hiroshi Mabuchi, Yoshiaki Tsuyuki, Koichiro Murata, Kensuke Takabayashi, Hisato Nakai, Daisuke Sueta, Wataru Shioyama, Tomohiro Dohke, Ryusuke Nishikawa, Koh Ono, Takeshi Kimura, on behalf of the COMMAND VTE Registry-2 Investigators
Institutions: Kyoto University, Hyogo Medical University, Kurashiki Central Hospital, Hyogo Prefectural Amagasaki General Medical Center, Toho University Ohashi Medical Center, Osaka Red Cross Hospital, Nagasaki University, Kobe City Medical Center General Hospital, Kitano Hospital, Kindai University Hospital, Japanese Red Cross Society Wakayama Medical Center, Otsu Red Cross Hospital, Tokyo Women's Medical University, Kobe University Hospital, Tenri Hospital, Mie University, Kansai Electric Power (Japan), Kansai Electric Power Hospital, Saiseikai Noe Hospital, Kindai University Nara Hospital, Kindai University, Gunma University, Kokura Memorial Hospital, Kyoto Medical Center, Koto Hospital, Koto Memorial Hospital, Shimada Municipal Hospital, Shizuoka City Hospital, Hirakata Kohsai Hospital, Sugita Genpaku Memorial Obama Municipal Hospital, Kumamoto University, Shiga University of Medical Science, Kohka Public Hospital
Language: English
Subfield: Internal Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4414537129