Real-life trends of anticoagulant prescribing practices for pulmonary embolism - results of a single-center study based on the experience of a multi-profile clinical hospital

Acute pulmonary embolism (APE) is one of the main causes of cardiovascular deaths and anticoagulant treatment plays a key role in preventing recurrent episodes, chronic thromboembolic pulmonary hypertension (CTEPH), and deaths. The aim of this study is to assess the real-life trends and to determine factors associated with the choice of anticoagulation therapy in patients with APE. This is a single center prospective open study. We followed 178 consecutive patients admitted to the tertiary clinical center with APE proven with computed tomography (CT) scan within period of 24 months. A total number of 178 patients with APE were enrolled in the study. 48.9% of subjects were hospitalized in cardiology department. As a prolonged anticoagulant therapy 35.7% of study cohort received direct oral anticoagulants (DOACs), 35.1% LMWH, and 29.2% vitamin K antagonists (VKA), respectively. No statistically significant differences were found between the departments regarding frequency of prescribing anticoagulants (p=0.15). The multivariable analysis showed that oral anti-coagulants (OACs) were less likely to be prescribed than LMWH in patients with malignancy, history of major bleeding, serious medical condition and altered mental status. OACs were preferred over LMWH in symptoms of deep vein thrombosis (DVT). VKA were significantly less likely to be chosen than DOACs in patients with history of orthopaedics procedure. After six months anticoagulation therapy was discontinued in 24.3% of patients. Concluding, the form of anticoagulant therapy was associated with the presence of chronic diseases. LMWH was prescribed in high bleeding risk patients more frequently.