AI Article Synopsis
- The study investigates how switching from warfarin to non-vitamin K oral anticoagulants (NOACs) affects the risk of major bleeding events in adults with atrial fibrillation.
- Researchers analyzed a claims database from 2010 to 2015 and found that patients who switched to NOACs had fewer potential drug-drug interactions compared to those who stayed on warfarin.
- While the study identified that more potential drug-drug interactions were linked to a higher risk of bleeding, it did not find a direct connection between switching to NOACs and an increase in major bleeding events.
Article Abstract
Purpose: This study aims to evaluate the associations between switching from warfarin to non-vitamin K oral anticoagulants (NOACs), exposure to potential drug-drug interactions (DDIs), and major bleeding events in working-age adults with atrial fibrillation (AF).
Methods: We conducted a retrospective cohort study using the claims database of commercially insured working-age adults with AF from 2010 to 2015. Switchers were defined as patients who switched from warfarin to NOAC; non-switchers were defined as those who remained on warfarin. We developed novel methods to calculate the number and proportion of days with potential DDIs with NOAC/warfarin. Multivariate logistic regressions were utilized to evaluate the associations between switching to NOACs, exposure to potential DDIs, and major bleeding events.
Results: Among a total of 4126 patients with AF, we found a significantly lower number of potential DDIs and the average proportion of days with potential DDIs in switchers than non-switchers. The number of potential DDIs (AOR 1.14, 95% CI 1.02-1.27) and the HAS-BLED score (AOR 1.64, 95% CI 1.48-1.82) were significantly and positively associated with the likelihood of a major bleeding event. The proportion of days with potential DDIs was also significantly and positively associated with risk for bleeding (AOR 1.42, 95% CI 1.03, 1.96). We did not find significant associations between switching to NOACs and major bleeding events.
Conclusions: The number and duration of potential DDIs and patients' comorbidity burden are important factors to consider in the management of bleeding risk in working-age AF adults who take oral anticoagulants.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6468989 | PMC |
| http://dx.doi.org/10.1007/s10557-018-6825-7 | DOI Listing |
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