PB0435 - Anticoagulant use in Malaysian patients with venous thromboembolism: a single-center retrospective study.

Sunday, June 23, 2024

13:45 – 14:45 ICT

Room: Exhibition Hall

Presenting Author(s)

Shasha Khairullah, MBChB(Bristol), MRCP(UK),MMed(UM),DipRCPath Haematology (UK), Fellowship in Clinical Haematology (Malaysia)

Haematology Consultant
University of Malaya
Wilayah Persekutuan, Kuala Lumpur, Malaysia

Co-Author(s)

KT

Kevin Tey Wen Fei

Researcher Haematology Unit
University of Malaya
Wilayah Persekutuan, Kuala Lumpur, Malaysia
LC

Liong Chee Chiat

Haematology Consultant
University of Malaya
Wilayah Persekutuan, Kuala Lumpur, Malaysia
CC

Cheong Chin Sum

Haematology Consultant
University of Malaya
Wilayah Persekutuan, Kuala Lumpur, Malaysia
MZ

Mohd Yazid Zamri

Haematology lecturer
University of Malaya
Wilayah Persekutuan, Kuala Lumpur, Malaysia
EC

Edmund Chin Fui Min

Haematology Consultant
University of Malaya
Wilayah Persekutuan, Kuala Lumpur, Malaysia
GG

Gan Gin Gin

Haematology Consultant
University of Malaya
Wilayah Persekutuan, Kuala Lumpur, Malaysia
BP

Bee Ping Chong

Haematology Consultant
University Malaya
Wilayah Persekutuan, Kuala Lumpur, Malaysia

Background: The incidence of venous thromboembolism (VTE) in the Asian population is reported to be lower than that recorded in western populations. With better awareness, improvement in healthcare and an ageing population, the numbers are expected to increase over time. Anticoagulation is the standard treatment for VTE. Direct oral anticoagulants (DOACs) are currently surpassing vitamin K antagonists (VKAs) as the anticoagulant of choice. There is limited data with regards to the effects of anticoagulants on Malaysian patients with VTE.

Aims: This study aims to evaluate safety and efficacy outcomes between different anticoagulants for Malaysian patients with VTE.

Methods: A retrospective analysis of patients with VTE from January 2016 to December 2020 at University of Malaya Medical Centre, Kuala Lumpur was performed. Treated patients were divided into 3 categories based on the anticoagulant used: those on warfarin, DOACs or LMWH. Baseline demographics and clinical characteristics related to VTE were also obtained.

Results: There were 839 cases of VTE identified (male patients 43.3%; median age 65 years) with 737 cases (89.6%) treated for VTE. Majority of patients were treated with DOACs (n=468, 63.5%) followed by LMWH (n=177, 24%) and warfarin (n=92, 12.4%). When compared to warfarin, DOACS and LMWH show a reduction in recurrent VTE (IR: 6.6% and 2.8% vs 7,6%) and a slight increase in overall bleeding rates (IR 9.2% and 4.5% vs 3.3%). However the changes were not found to be significant (recurrent VTE p=0.815 and 0.099; overall bleeding p=0.670 and 0.319). Overall mortality has been shown to be significantly higher in patients on LMWH (HR: 3.32, CI: 2.115-5.223) reflecting its increased use in critically ill and elderly patients.

Conclusion(s): Efficacy and safety of DOACs and LMWH appear to be comparable to that of VKA among Malaysian patients with VTE.