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Eur Heart J Cardiovasc Pharmacother. 2018 Oct 1;4(4):220-227. doi: 10.1093/ehjcvp/pvy021.

Safety and effectiveness of rivaroxaban and apixaban in patients with venous thromboembolism: a nationwide study.

Author information

Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Kildegaardsvej 28, Hellerup, Denmark.
Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen N, Denmark.
Department of Medicine, New York University School of Medicine, 530 First Avenue, Skirball 9R, New York, NY, USA.
The Danish Heart Foundation, Vognmager gade 7, Copenhagen K, Copenhagen, Denmark.
Department of Public Health, Section of Biostatistics, University of Copenhagen, Øster Farimagsgade 5, Copenhagen K, Denmark.
Department of Health Science and Technology, Public Health and Epidemiology Group, Aalborg University Hospital, Niels Jernes Vej 12, Aalborg Ø, Denmark.
Department of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9B, Odense C, Denmark.



To investigate the risk of all-cause mortality, recurrent venous thromboembolism (VTE), and hospitalized bleeding in patients with VTE treated with either rivaroxaban or apixaban.

Methods and results:

Using Danish nationwide registries, patients with VTE treated with rivaroxaban or apixaban in the period from 1 January 2015 to 30 June 2017 were identified. Standardized absolute risks were estimated based on outcome-specific Cox regression models, adjusted for potential confounders. A total of 8187 patients were included in the study, of which 1504 (18%) were treated with apixaban [50% males, median age 70 years; interquartile range (IQR) 56-80] and 6683 (82%) were treated with rivaroxaban (55% males, median age 67 years; IQR 53-76). The 180 days risk of all-cause mortality was 5.08% [95% confidence interval (95% CI) 4.08% to 6.08%)] in the apixaban group and 4.60% (95% CI 4.13% to 5.18%) in the rivaroxaban group [absolute risk difference: -0.48% (95% CI -1.49% to 0.72%)]. The 180 days risk of recurrent VTE was 2.16% (95% CI 1.49% to 2.88%) in the apixaban group and 2.22% (95% CI 1.89% to 2.52%) in the rivaroxaban group [absolute risk difference of 0.06% (95% CI -0.72% to 0.79%)]. The 180 days risk of hospitalized bleeding was 1.73% (95% CI 1.22% to 2.35%) for patients in the apixaban group and 1.89% (95% CI 1.56% to 2.20%) in the rivaroxaban group [absolute risk difference: 0.16% (95% CI -0.59% to 0.81%)].


In a nationwide cohort of 8187 patients with VTE treated with rivaroxaban or apixaban, there were no significant differences in the risks of all-cause mortality, recurrent VTE, or hospitalized bleeding.


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