AI Article Synopsis
- Randomized controlled trials (RCTs) found that dabigatran, rivaroxaban, and warfarin have comparable bleeding rates in patients with atrial fibrillation (AF).
- A retrospective study analyzed the incidence of bleeding in 18,249 AF patients starting these anticoagulants over three years, with bleeding monitored per 100 patient-years.
- Results showed similar bleeding rates for all three drugs, with dabigatran and rivaroxaban demonstrating rates comparable to warfarin, while rivaroxaban had the lowest rates of intracranial and gastrointestinal hemorrhages.
Article Abstract
Backgound: Randomized controlled trials (RCTs) have shown that dabigatran, rivaroxaban and warfarin cause similar bleeding rates.
Methods: We performed a retrospective population-based cohort study to determine the incidence of bleeding in patients with atrial fibrillation (AF) beginning dabigatran, rivaroxaban or warfarin. Consecutive patients initiating anticoagulation for AF during a 3year period were identified using a computerized database. Patients who bled and required hospitalization underwent chart review. Bleeding incidences were calculated per 100 patient-years of treatment.
Results: 18,249 patients were included: 9564 (52.4%) received warfarin, 5976 (32.7%) dabigatran, and 2709 (14.8%) rivaroxaban. Bleeding incidences were 3.9 (95% CI, 3.6-4.4) in warfarin-treated patients, 4.2 (95% CI, 3.7-4.7) in dabigatran patients, and 4.1 (95% CI, 3.0-5.3) in rivaroxaban patients. Intracranial hemorrhage (ICH) rates were 0.71 (95% CI, 0.56-0.90) for warfarin, 0.4 (95% CI, 0.18-0.87) for dabigatran, and 0.27 (95%CI, 0.10-0.80) for rivaroxaban. GI hemorrhage rates were 1.88 (95%CI, 1.62-2.20) for warfarin, 2.98 (95% CI, 2.4-3.5) for dabigatran and 2.39 (95%CI, 1.6-3.5) for rivaroxaban.
Conclusions: We demonstrate similar bleeding rates with both dabigatran 150mg and 110mg and rivaroxaban compared to warfarin.
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| http://dx.doi.org/10.1016/j.ejim.2016.05.023 | DOI Listing |
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