---
title: "DOAC versus Warfarin for Non‑Triple‑Positive APS‑Related Pulmonary Embolism: Efficacy and Safety"
id: "pubmed-42706207"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42706207"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42706207/"
doi: "10.3760/cma.j.cn112147-20251214-00789"
published_at: "2026-09-12T00:00:00.000Z"
evidence_level: "English Abstract"
license: "CC-BY-NC-4.0 / Informational Use"
---
# DOAC versus Warfarin for Non‑Triple‑Positive APS‑Related Pulmonary Embolism: Efficacy and Safety
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42706207
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42706207/)
- **DOI:** [10.3760/cma.j.cn112147-20251214-00789](https://doi.org/10.3760%2Fcma.j.cn112147-20251214-00789)
- **Published At:** 2026-09-12T00:00:00.000Z
- **Evidence Rating:** English Abstract
## Executive GIST (TL;DR)
- Study type: retrospective single‑center analysis of antiphospholipid syndrome (APS) patients with pulmonary thromboembolism (PTE) who met the Sapporo diagnostic criteria, treated from July 2016 to July 2021 at The First Affiliated Hospital of Chongqing Medical University. - Population: 43 patients total; **DOAC** group n=34 (19 males, 16 females, mean age 57.0±17.7 years), warfarin group n=9 (3 males, 6 females, mean age 37.7±15.0 years). Age differed between groups; other baseline variables did not show statistically significant differences. - Efficacy outcomes: Venous thromboembolism (VTE) recurrence occurred in 2 of 34 (5.9%) in the **DOAC** group and 0 of 9 in the warfarin group. The difference in recurrence rates was not statistically significant (P = 1.000). - Mortality: No deaths occurred in either treatment group during follow‑up; no statistically significant difference in mortality was observed. - Safety outcomes: Anticoagulation‑related bleeding occurred in 4 of 34 (11.8%) in the **DOAC** group and 3 of 9 in the warfarin group. Reported risk ratio was 0.353 (95% CI: 0.096–1.301); the difference was not statistically significant (P = 0.147). - Conclusion reported by authors: **DOAC** may be non‑inferior to warfarin in both efficacy and safety for treatment of **non‑triple‑positive APS**‑associated **PTE**, based on this retrospective cohort. - Study limitations reported or not reported in the abstract: The abstract does not provide details on duration of follow‑up, specific DOAC agents or dosing, time in therapeutic range for warfarin, or adjustment for confounders; those details were not reported in the source abstract. - Conflict of interest: All authors declared no competing interests. - Publication details: Article in Chinese with English abstract; Zhonghua Jie He He Hu Xi Za Zhi. PMID 42706207; DOI 10.3760/cma.j.cn112147-20251214-00789.
## Clinical Analysis & Structured Key Points
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Affiliations Expand ### Affiliation * 1 Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016. * PMID: **42706207** * DOI: [ 10.3760/cma.j.cn112147-20251214-00789 ](https://doi.org/10.3760/cma.j.cn112147-20251214-00789) Item in Clipboard # [Efficacy and safety of direct oral anticoagulants for the treatment of non-triple-positive antiphospholipid syndrome-associated pulmonary thromboembolism] [Article in Chinese] C C Hu et al. Zhonghua Jie He He Hu Xi Za Zhi. 2026. Show details Display options Display options Format Abstract PubMed PMID Zhonghua Jie He He Hu Xi Za Zhi Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Zhonghua+Jie+He+He+Hu+Xi+Za+Zhi%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Zhonghua+Jie+He+He+Hu+Xi+Za+Zhi%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42706207/) . 2026 Sep 12;49(9):998-1004. doi: 10.3760/cma.j.cn112147-20251214-00789. ### Authors [C C Hu](https://pubmed.ncbi.nlm.nih.gov/?term=Hu+CC&cauthor_id=42706207)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42706207/#short-view-affiliation-1 "Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016."), [X H Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+XH&cauthor_id=42706207)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42706207/#short-view-affiliation-1 "Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016."), [H Chen](https://pubmed.ncbi.nlm.nih.gov/?term=Chen+H&cauthor_id=42706207)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42706207/#short-view-affiliation-1 "Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016.") ### Affiliation * 1 Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016. * PMID: **42706207** * DOI: [ 10.3760/cma.j.cn112147-20251214-00789 ](https://doi.org/10.3760/cma.j.cn112147-20251214-00789) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract in [ English, ](https://pubmed.ncbi.nlm.nih.gov/42706207/#eng-abstract) [ Chinese ](https://pubmed.ncbi.nlm.nih.gov/42706207/#zho-abstract) **Objective:** To evaluate the efficacy and safety of direct oral anticoagulants (DOAC) in the treatment of non-triple-positive antiphospholipid syndrome (APS)-associated pulmonary thromboembolism (PTE). **Methods:** A retrospective analysis was conducted on APS patients who were definitively diagnosed with PTE at the First Affiliated Hospital of Chongqing Medical University from July 2016 to July 2021 and met the Sapporo diagnostic criteria. Patients were divided into a DOAC group (_n_ =34; 19 males, 16 females, mean age 57.0±17.7 years) and a warfarin group (_n_ =9; 3 males, 6 females, mean age 37.7±15.0 years) based on the type of oral anticoagulant. Baseline data and laboratory findings were collected for both groups. Efficacy and safety outcomes, including venous thromboembolism (VTE) recurrence, death, and anticoagulation-related bleeding, were compared between the two groups. **Results:** No statistically significant differences were observed in baseline data between the two groups except for age. In terms of efficacy, thrombosis recurrence occurred in 2 patients (5.9%) in the DOAC group, while no recurrence occurred in the warfarin group; there was no statistically significant difference in VTE recurrence between the 2 groups (_P_ =1.000). No deaths occurred in either group during follow-up, with no statistically significant difference in mortality. Regarding safety, bleeding occurred in 4 patients (4/34, 11.8%) in the DOAC group and 3 patients in the warfarin group, with a risk ratio of 0.353 (95% confidence interval: 0.096-1.301); the difference was not statistically significant (_P_ =0.147). **Conclusion:** DOAC may be non-inferior to warfarin in both efficacy and safety for the treatment of non-triple-positive APS-associated PTE. **目的：** 观察直接口服抗凝药（DOAC）治疗非三阳抗磷脂综合征（APS）相关肺血栓栓塞症（PTE）的有效性和安全性。 **方法：** 回顾性分析2016年7月至2021年7月于重庆医科大学附属第一医院明确诊断为PTE，并符合Sapporo诊断标准的APS患者，根据口服抗凝药的类型分为DOAC组和华法林组。DOAC组共纳入患者34例，其中男19例，女16例，年龄（57.0±17.7）岁；华法林组共纳入患者9例，其中男3例，女6例，年龄（37.7±15.0）岁。收集2组患者的基线数据资料和实验室检查结果，并对2组患者的静脉血栓栓塞症（VTE）血栓复发、死亡及抗凝出血等资料进行有效性和安全性分析。 **结果：** 2组患者除年龄外，其余基线资料差异均无统计学意义（ _P_ >0.05）。在有效性方面：DOAC组2例（2/34，5.9%）患者出现血栓复发，华法林组没有出现复发病例，2组患者在VTE血栓复发方面差异无统计学意义（ _P_ =1.000）；两组患者在随访期间均未出现死亡的情况。在安全性方面：DOAC组4例（4/34，11.8%）发生出血，华法林组3例发生出血，2组风险比为0.353（95%_CI_ ：0.096~1.301），结果差异无统计学意义（ _P_ =0.147）。 **结论：** DOAC对比华法林治疗非三阳APS相关PTE，在有效性和安全性方面可能具有非劣效性。. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement 所有作者声明无利益冲突 ## Similar articles * [ Effectiveness and Safety of Direct Oral Anticoagulants versus Warfarin in Obese Patients with Acute Venous Thromboembolism. ](https://pubmed.ncbi.nlm.nih.gov/31968126/) Coons JC, Albert L, Bejjani A, Iasella CJ.Coons JC, et al.Pharmacotherapy. 2020 Mar;40(3):204-210. doi: 10.1002/phar.2369. Epub 2020 Feb 11.Pharmacotherapy. 2020.PMID: 31968126 * [ Direct oral anticoagulants in the treatment of chronic thromboembolic pulmonary hypertension patients: A retrospective cohort study. ](https://pubmed.ncbi.nlm.nih.gov/38936635/) Chong LT, Hu S, Guo TT, Gao X, Tan JS, Liu ZQ, Deng YR, Wei YX, Hua L.Chong LT, et al.Respir Med. 2024 Sep;231:107722. doi: 10.1016/j.rmed.2024.107722. 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> MedicHelpline content is structured for research, educational, and professional discovery purposes. It does not constitute individual medical advice, clinical diagnosis, or treatment recommendations.
> Always verify dosing, contraindications, and regulatory alerts against official product labeling and primary regulatory sources before clinical decision-making.