Category: Federal Forum Posters
Purpose: Effectiveness of direct oral anticoagulants (DOACs) in prevention of deep vein thrombosis (DVT), pulmonary embolism (PE), and stroke prevention in atrial fibrillation (Afib) is unknown for obese patients (BMI greater than or equal to 30kg per m2). Given the morbidity and mortality associated with stroke, DVT, and PE, a better understanding of the clinical significance extreme body weight has on the efficacy of these agents is warranted. This study evaluates if there is a difference in effectiveness of DOACs in obese patients compared to patients of normal weight for the prevention of stroke, and the reoccurrence of DVT, and PE.
Methods: This is a retrospective, multicenter, cohort study utilizing clinical data from veterans prescribed apixaban, rivaroxaban, edoxaban, or dabigatran with a history of DVT, PE, or Afib. The purpose of this study is to determine the efficacy of these agents in obese patients with a BMI greater than or equal to 30kg per m2 and secondary analysis of BMI greater than or equal to 40 kg per m2 compared to patients of normal weight. Data will be extracted and maintained within the VA Informatics and Computing Infrastructure (VINCI) workspace and will be collected up to December 31, 2017. The primary composite outcome of the study will be the recurrence of DVT, PE, or incidence of stroke in obese patients prescribed direct oral anticoagulants (DOACs) compared to those of a normal body weight. The secondary outcomes of this study will include analysis of effectiveness of these agents in extreme obesity compared to normal weight, incidence of major bleeding event, death from vascular event, and DVT, PE, or stroke occurrence.
Results: Not applicable
Conclusion: Not applicable
Samantha Ramm– Pharmacy Resident, VA Eastern Kansas Health Care System, Kansas City, MO