Virtual ACC 2020 | CARAVAGGIO: Apixaban in Venous Thromboembolism Associated to Cancer

Oral apixaban resulted non-inferior to subcutaneous dalteparin in the treatment of venous thromboembolism associated to cancer with no increase in major bleeding.

The most recent guidelines recommend the use of edoxaban or rivaroxaban for the treatment of venous thromboembolism associated to cancer.  However, the evidence of new anticoagulants in this context is limited and the greatest concern is bleeding increase. 

The CARAVAGGIO randomized over 1100 consecutive patients consecutive patients with cancer who had symptomatic or incidental acute proximal deep-vein thrombosis or pulmonary embolism to receiving apixaban (10 mg twice a day for a week and 5 mg a day thereafter) vs subcutaneous dalteparin (200 UI/kg once a day for the first month followed by 150 UI/kg a day). The treatment was administered for 6 months. 

Recurrent thromboembolism (primary efficacy end point) occurred in 5.6% of patients in the apixaban group vs 7.9% in the dalteparin group (p<0.001 for non-inferiority).


Read also: Virtual ACC 2020 | PRECOMBAT: 10 Years for Surgery vs. Angioplasty in Left Main Coronary Artery Disease.


Major bleeding happened in 3.8% of patients in the apixaban group vs 4% in the dalteparin group (p=0.6).

Conclusion

Oral apixaban resulted non-inferior to subcutaneous dalteparin in the treatment of venous thromboembolism associated to cancer with no increase in major bleeding risk. 

caravaggio

Original Title: Apixaban for the Treatment of Venous Thromboembolism Associated with Cancer.

Reference: Giancarlo Agnelli et al. NEJM online before print y presentado en forma virtual en el ACC 2020.


Subscribe to our weekly newsletter

Get the latest scientific articles on interventional cardiology

We are interested in your opinion. Please, leave your comments, thoughts, questions, etc., below. They will be most welcome.

More articles by this author

TAVR and Anticoagulation: What Should We Do?

Transcatheter aortic valve replacement (TAVR) has consolidated as a valid strategy for certain groups of patients. However, approximately one third of those who require...

Direct Oral Anticoagulants for Ventricular Thrombus After STEMI

While the incidence of intracavitary thrombi after acute myocardial infarction (AMI) has decreased thanks to optimized primary angioplasty times, some studies report rates of...

AHA 2024 | VANISH2 Trial

Cardiac defibrillator implants (CDIs) have been shown to improve survival in patients with ischemic cardiomyopathy and ventricular tachycardia (VT). However, approximately one third of...

AHA 2024 | SUMMIT

It has been previously shown that the pharmacological treatment of obesity (semaglutide) can reduce cardiovascular events in patients with cardiac failure (CF) and preserved...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

Unplanned Coronary Angiography After TAVR: Incidence, Predictors, and Outcomes

The importance of assessing coronary artery disease in patients undergoing transcatheter aortic valve replacement (TAVR) is well recognized due to the high prevalence of...

Intravascular Lithotripsy in Calcified Coronary Lesions: Success Predictors

Coronary artery calcification (CAC) is increasingly common in patients undergoing percutaneous coronary intervention (PCI). Intravascular lithotripsy (IVL) has been established as an effective tool...

TAVR Unload: TAVR in Moderate Aortic Stenosis and Ventricular Function Deterioration

Aortic Stenosis (AS) significantly contributes to valvulo-arterial impedance in patients with heart failure and reduced ejection fraction (HFrEF), making it a relevant therapeutic target...