{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T04:45:56Z","timestamp":1772772356942,"version":"3.50.1"},"reference-count":34,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T00:00:00Z","timestamp":1759708800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["JCDD"],"abstract":"<jats:p>Background: Pulmonary embolism (PE) is a major cause of cardiovascular morbidity and mortality. Guidelines favor direct oral anticoagulants (DOACs) over vitamin K antagonists (VKAs), but real-world Croatian data are scarce. Methods: A prospective dual-center registry included 773 patients discharged with acute PE between 2013 and 2024. Clinical, laboratory, and socioeconomic data were collected. The primary outcome was all-cause mortality; secondary outcomes were recurrent venous thromboembolism (VTE) and major bleeding. Results: DOAC users were younger, with higher education and income, than VKA or heparin patients. Median follow-up was 1106 days. Mortality reached 60.3% with VKA, 26.0% with DOAC, and 84.1% with heparin (p &lt; 0.001). VTE recurrence did not differ significantly. Major bleeding occurred in 9.3% of VKA versus 2.9% of DOAC patients (p = 0.003). Adjusted analysis showed a lower mortality risk with DOAC versus VKA (HR 0.62, 95% CI 0.48\u20130.80, p &lt; 0.001), while heparin predicted higher mortality (HR 3.63, 95% CI 2.54\u20135.21, p &lt; 0.001). Higher PESI class independently increased mortality and recurrence. Conclusion: In the first Croatian PE cohort, DOACs were linked to reduced mortality and bleeding risk compared with VKAs, with similar recurrence. Clinical, socioeconomic, and policy factors strongly influenced prescribing patterns and outcomes.<\/jats:p>","DOI":"10.3390\/jcdd12100394","type":"journal-article","created":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T13:33:41Z","timestamp":1759757621000},"page":"394","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Real-World Patterns and Outcomes of Anticoagulation Therapy in Pulmonary Embolism: An Observational Dual-Centre Registry Analysis"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2637-9691","authenticated-orcid":false,"given":"Ivana","family":"Jurin","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Dubrava University Hospital, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7500-8256","authenticated-orcid":false,"given":"Josip","family":"Peji\u0107","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Thoracic Surgery, University Hospital Dubrava, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9137-3014","authenticated-orcid":false,"given":"Karlo","family":"Gjuras","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Health Centre Bjelovar-Bilogora County, 43000 Bjelovar, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1428-3940","authenticated-orcid":false,"given":"Fran","family":"\u0160aler","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Dubrava University Hospital, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1845-4871","authenticated-orcid":false,"given":"Tea-Terezija","family":"Cvetko","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Dubrava University Hospital, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5377-0269","authenticated-orcid":false,"given":"Nevenka","family":"Piska\u010d \u017divkovi\u0107","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Hospital Dubrava, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9896-1234","authenticated-orcid":false,"given":"Zdravko","family":"Mitrovi\u0107","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Hospital Dubrava, 10000 Zagreb, Croatia"},{"name":"School of Medicine, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9526-3393","authenticated-orcid":false,"given":"\u0160ime","family":"Manola","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Dubrava University Hospital, 10000 Zagreb, Croatia"},{"name":"School of Medicine, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3962-2774","authenticated-orcid":false,"given":"Marin","family":"Pavlov","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Dubrava University Hospital, 10000 Zagreb, Croatia"},{"name":"Professional Undergraduate Study Physiotherapy, University North, 48000 Koprivnica, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3404-3837","authenticated-orcid":false,"given":"Aleksandar","family":"Blivajs","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Dubrava University Hospital, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4004-7271","authenticated-orcid":false,"given":"Kristina","family":"Mari\u0107 Be\u0161i\u0107","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Zagreb, 10000 Zagreb, Croatia"},{"name":"Department of Cardiovascular Diseases, University Hospital Centre Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4269-6881","authenticated-orcid":false,"given":"Dalibor","family":"Divkovi\u0107","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Hospital Center Osijek, 31000 Osijek, Croatia"},{"name":"Faculty of Medicine, University Josip Juraj Strossmayer of Osijek, 31000 Osijek, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3768-9134","authenticated-orcid":false,"given":"Irzal","family":"Had\u017eibegovi\u0107","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Dubrava University Hospital, 10000 Zagreb, Croatia"},{"name":"Faculty of Dental Medicine and Health Care, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1055\/s-0034-1390325","article-title":"Thrombosis: A major contributor to global disease burden","volume":"40","author":"Raskob","year":"2014","journal-title":"Semin. 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