Most Blood Clot Treatments Were Equally Effective

Unfractionated heparin and vitamin K antagonist combination associated with higher risk of bleeding

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) Doctors have a number of ways to treat blood clots. But a new study suggests these treatments may not differ much in how well they work.

A new study compared the safety and effectiveness of the treatments.

With one exception, the study authors found similar patient outcomes for most blood clot treatments.

"Discuss all blood clot treatment options with your cardiologist."

Marc Carrier, MD, and colleagues reviewed 45 studies to compare treatments for blood clots in 444,989 patients.

Blood clots form in the veins and can break loose and obstruct blood flow. Blood clots that break loose (venous thromboembolisms) are the third leading cause of death related to the heart.

The normal treatments for blood clots are blood thinners, unfractionated heparin (UFH), low-molecular-weight heparin (LMWH) or fondaparinux (brand name Arixtra). From there, doctors often move to a vitamin K antagonist (such as warfarin).

For this study, Dr. Carrier and team looked at patient outcomes of UFH, LMWH and fondaparinux in combination with a vitamin K antagonist.

They also studied rivaroxaban (brand name Xarelto), apixaban (Eliquis), LMWH alone, and LMWH combined with both dabigatran (Pradaxa) and edoxaban (Lixiana).

Except for the UFH and vitamin K antagonist combo, “All management options … were associated with similar clinical outcomes,” the authors wrote.

Of the patients on the UFH-vitamin K antagonist treatment, 1.84 percent had blood clots come back within three months.

Of the patients on the normal LMWH-vitamin K antagonist treatment, 1.30 percent had blood clots come back within three months.

Rivaroxaban and apixaban were associated with the lowest bleeding risk — compared to the LMWH-vitamin K antagonist treatment.

The authors wrote that their findings “are clinically relevant and are what clinical practice guidelines recommendations are based on.”

The study was published online Sept. 16 in JAMA.

The Heart and Stroke Foundation of Canada, Canadian Institutes of Health Research and the Heart and Stroke Foundation of Ontario funded the research. Four co-authors received funds for research and speaking from private companies.

Review Date: 
September 15, 2014
Last Updated:
September 16, 2014