Can DOACs Prevent Thromboembolic Events in Patients With Morbid Obesity?

Anticoagulation therapy with direct oral anticoagulants (DOAC) can be a safe and effective way to prevent thromboembolic events in patients who are morbidly obese, according to research presented at CHEST 2018.


The report, authored by Charlene Kalani, PharmD, and colleagues, was presented on Wednesday, October 10, at CHEST Annual Meeting 2018 in San Antonio.


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To reach their conclusions, the researchers studied 180 patient records from Corpus Christi Medical Center. They compared the rates of thromboembolic events—including deep vein thrombosis (DVT), ischemic stroke, and myocardial infarction (MI)—in patients who were morbidly obese and were taking DOACs with patients who were morbidly obese and taking warfarin for anticoagulation.


Of the 90 patients who were taking DOACs, 3 had an ischemic stroke, 3 developed DVT, 1 developed a pulmonary embolism (PE), and 4 had MIs. Two patients in the DOAC group had major bleeding events.


Of the 90 patients who were taking warfarin, 3 had an ischemic stroke, 2 developed DVT, 2 developed a PE, and 3 had MIs. Three patients in the warfarin group had major bleeding events.


“Larger studies are necessary to confirm these findings,” the researchers concluded. “This is a hypothesis-generating study demonstrating that apixaban, dabigatran, and rivaroxaban may be safe and effective anticoagulants in morbidly obese patients.”


—Colleen Murphy



Kalani C, Awudi Henry E, Alexander T, Udeani G, Surani S. Efficacy and safety of direct oral anticoagulants (DOACS) in morbidly obese patients. Paper presented at: CHEST Annual Meeting 2018; October 6-10, 2018; San Antonio, TX. Accessed October 18, 2018.