{"id":30443,"date":"2026-03-24T04:20:00","date_gmt":"2026-03-23T20:20:00","guid":{"rendered":"https:\/\/csccm.org.cn\/?p=30443"},"modified":"2026-03-24T05:32:45","modified_gmt":"2026-03-23T21:32:45","slug":"nejm%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e6%80%a5%e6%80%a7%e9%9d%99%e8%84%89%e8%a1%80%e6%a0%93%e6%a0%93%e5%a1%9e%e6%82%a3%e8%80%85%e4%bd%bf%e7%94%a8%e9%98%bf%e5%93%8c%e6%b2%99%e7%8f%ad","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=30443","title":{"rendered":"[NEJM\u53d1\u8868\u8bba\u6587]\uff1a\u6025\u6027\u9759\u8109\u8840\u6813\u6813\u585e\u60a3\u8005\u4f7f\u7528\u963f\u54cc\u6c99\u73ed\u6216\u5229\u4f10\u6c99\u73ed\u7684\u51fa\u8840\u98ce\u9669"},"content":{"rendered":"\n

ORIGINAL ARTICLE<\/a><\/p>\n\n\n\n

Bleeding Risk with Apixaban vs. Rivaroxaban in Acute Venous Thromboembolism<\/h1>\n\n\n\n

Lana A.\u00a0Castellucci,\u00a0Vivien M.\u00a0Chen,\u00a0Michael J.\u00a0Kovacs,\u00a0et al<\/h3>\n\n\n\n

N Engl J Med\u00a02026;394:1051-1060<\/h3>\n\n\n\n

DOI: 10.1056\/NEJMoa2510703<\/h3>\n\n\n\n

Abstract<\/h2>\n\n\n\n

BACKGROUND<\/h3>\n\n\n\n

Apixaban and rivaroxaban are the oral anticoagulants most frequently used to treat acute venous thromboembolism. However, uncertainty remains about the difference in bleeding risk between the two medications.<\/p>\n\n\n\n

METHODS<\/h3>\n\n\n\n

In an international trial with a prospective, randomized, open-label, blinded end-point design, we assigned, in a 1:1 ratio, eligible patients with acute symptomatic pulmonary embolism or proximal deep-vein thrombosis to receive apixaban or rivaroxaban for 3 months. Apixaban was given at a dose of 10 mg twice daily for 7 days followed by 5 mg twice daily, and rivaroxaban was given at a dose of 15 mg twice daily for 21 days followed by 20 mg daily. The primary outcome was clinically relevant bleeding, a composite of major bleeding or clinically relevant nonmajor bleeding, as defined according to the International Society on Thrombosis and Haemostasis, during the 3-month trial period. Secondary outcomes included death from any cause.<\/p>\n\n\n\n

RESULTS<\/p>\n\n\n\n

A total of 2760 patients underwent randomization: 1370 to the apixaban group and 1390 to the rivaroxaban group. A primary-outcome event occurred in 44 of 1345 patients (3.3%) in the apixaban group and 96 of 1355 patients (7.1%) in the rivaroxaban group (relative risk, 0.46; 95% confidence interval [CI], 0.33 to 0.65; P<0.001). Death from any cause occurred in 1 patient (0.1%) in the apixaban group and in 4 patients (0.3%) in the rivaroxaban group (relative risk, 0.25; 95% CI, 0.03 to 2.26). Serious adverse events unrelated to bleeding or venous thrombosis occurred in 36 patients (2.7%) in the apixaban group and in 30 patients (2.2%) in the rivaroxaban group.<\/p>\n\n\n\n

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CONCLUSIONS<\/h3>\n\n\n\n

Among patients with acute venous thromboembolism, the risk of clinically relevant bleeding was significantly lower with apixaban than with rivaroxaban during the 3-month treatment period. (Funded by the Canadian Institutes of Health Research and others; COBRRA ClinicalTrials.gov number, NCT03266783<\/a>.)<\/p>\n","protected":false},"excerpt":{"rendered":"

ORIGINAL ARTICLE Bleeding Risk with Apixaban vs. Rivaro […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/30443"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=30443"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/30443\/revisions"}],"predecessor-version":[{"id":30449,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/30443\/revisions\/30449"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=30443"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=30443"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=30443"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}