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Turkish Society of Cardiology
Young Cardiologists
President
Dr. Muzaffer Değertekin
Coordinator for the
Board of Directors
Dr. Ertuğrul Okuyan
Coordinator for the
Board of Directors
Dr. Can Yücel Karabay
Members
Dr. Adem Aktan
Dr. Gülşah Aktüre
Dr. Bayram Arslan
Dr. İnanç Artaç
Dr. Ahmet Oğuz Aslan
Dr. Görkem Ayhan
Dr. Ahmet Anıl Başkurt
Dr. Özkan Bekler
Dr. Oğuzhan Birdal
Dr. Yusuf Bozkurt Şahin
Dr. Serkan Bulgurluoğlu
Dr. Ümit Bulut
Dr. Veysi Can
Dr. Mustafa Candemir
Dr. Murat Çap
Dr. Göksel Çinier
Dr. Ali Çoner
Dr. Yusuf Demir
Dr. Ömer Furkan Demir
Dr. Murat Demirci
Dr. Ayşe İrem Demirtola Mammadli
Dr. Süleyman Çağan Efe
Dr. Mehmet Akif Erdöl
Dr. Kubilay Erselcan
Dr. Kerim Esenboğa
Dr. Duygu Genç
Dr. Kemal Göçer
Dr. Elif Güçlü
Dr. Arda Güler
Dr. Duygu İnan
Dr. Hasan Burak İşleyen
Dr. Muzaffer Kahyaoğlu
Dr. Sedat Kalkan
Dr. Yücel Kanal
Dr. Özkan Karaca
Dr. Ahmet Karaduman
Dr. Mustafa Karanfil
Dr. Ayhan Kol
Dr. Fatma Köksal
Dr. Mevlüt Serdar Kuyumcu
Dr. Yunus Emre Özbebek
Dr. Ahmet Özderya
Dr. Yasin Özen
Dr. Ayşenur Özkaya İbiş
Dr. Çağlar Özmen
Dr. Selvi Öztaş
Dr. Hasan Sarı
Dr. Serkan Sivri
Dr. Ali Uğur Soysal
Dr. Hüseyin Tezcan
Dr. Nazlı Turan
Dr. Berat Uğuz
Dr. Örsan Deniz Urgun
Dr. İdris Yakut
Dr. Mustafa Yenerçağ
Dr. Mehmet Fatih Yılmaz
Dr. Yakup Yiğit
Dr. Mehmet Murat Yiğitbaşı
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HI-PRO: Apixaban for Extended Treatment of Provoked Venous ThromboembolismTürk Kardiyoloji Derneği Genç Kardiyologlar Bülteni - HI-PRO: Apixaban for Extended Treatment of Provoked Venous Thromboembolism (Dr. Emre Kipritçi)Study Title: HI-PRO: Apixaban for Extended Treatment of Provoked Venous Thromboembolism
Presented at: ESC 2025
Link: https://esc365.escardio.org/presentation/312188
Prapared By: Dr. Emre Kipritçi
Introduction
The duration of anticoagulation therapy for venous thromboembolism (VTE) is uncertain in patients with a transient provoking factor (such as surgery, immobilization, or trauma) accompanied by persistent risk factors (such as obesity, chronic liver disease, or autoimmune disorders). Observational studies have indicated that patients with venous thromboembolism (VTE) who have a transient provoking risk factor have a higher risk of recurrence if persistent provoking risk factors are present.
Objective
The HI-PRO study was conducted to evaluate the efficacy and safety of long-term low-dose apixaban in preventing the recurrence of VTE in patients with provoked VTE and at least one persistent risk factor.
Methods
The double-blind, randomized controlled HI-PRO study was conducted at a single center. Patients who developed DVT or pulmonary embolism (PE) following a provoking factor, had completed at least 3 months of standard-dose anticoagulation therapy, and had at least one persistent risk factor were included. Participants were randomized in a 1:1 ratio to receive either 2.5 mg of apixaban twice daily or placebo for 12 months. The primary efficacy outcome was symptomatic recurrent VTE, defined as a composite of DVT and/or PE within 12 months. The primary safety outcome was bleeding.
Results
A total of 600 patients were enrolled in the study. Of the participants, %57 were female, and the mean age was 59.5 years. Symptomatic recurrent VTE occurred in 4 out of 300 patients (1.3%) in the apixaban group and 30 out of 300 patients (10.0%) in the placebo group (p < 0.001). Major bleeding was observed in 1 patient in the apixaban group, while no major bleeding events occurred in the placebo group. Clinically relevant non-major bleeding was observed in 14 of 294 patients (4.8%) in the apixaban group and 5 of 294 patients (1.7%) in the placebo group (p = 0.06).
Conclusions
Treatment with 2.5 mg of apixaban twice daily for 12 months reduced symptomatic recurrent VTE compared to placebo.
Commentary
The HI-PRO study demonstrated that low-dose, long-term apixaban treatment reduces symptomatic VTE. Further studies are needed to identify subgroups that benefit the most from prolonged anticoagulation therapy.
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