Research
Print page Print page
Switch language
Rigshospitalet - a part of Copenhagen University Hospital
E-pub ahead of print

Direct oral anticoagulant- versus vitamin K antagonist-related gastrointestinal bleeding: Insights from a nationwide cohort

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Rationale and design of DanGer shock: Danish-German cardiogenic shock trial

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Risk of stroke subsequent to infective endocarditis: A nationwide study

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Prevalence and risk factors of prolonged QT interval and electrocardiographic abnormalities in persons living with HIV

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Association between Type D personality and outcomes in patients with non-ischemic heart failure

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Prevalence of infective endocarditis in patients with positive blood cultures: a Danish nationwide study

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

BACKGROUND: The purpose of the study was to examine the association between the type of preceding oral anticoagulant use (warfarin or direct oral anticoagulants [DOACs]) and in-hospital mortality among patients admitted with gastrointestinal bleeding.

METHODS: In this observational cohort study, all patients admitted with a first-time gastrointestinal bleeding from January 2011 to March 2017 while receiving any oral anticoagulant therapy prior to admission were identified using data from Danish nationwide registries. The risk of in-hospital mortality according to type of oral anticoagulation therapy was examined by multivariable logistic regression models.

RESULTS: Among 5,774 patients admitted with gastrointestinal bleeding (median age, 78 years [25th-75th percentile, 71-85 years]; 56.8% men), 2,038 (35.3%) were receiving DOACs and 3,736 (64.7%) were receiving warfarin prior to admission. The unadjusted in-hospital mortality rates were 7.5% for DOAC (7.2% for dabigatran, 6.4% for rivaroxaban, and 10.1% for apixaban) and 6.5% for warfarin. After adjustment for baseline demographic and clinical characteristics, there was no statistically significant difference in in-hospital mortality between prior use of any DOAC and warfarin (unadjusted odds ratio [OR] 1.18 [95% CI 0.95-1.45], adjusted OR 0.97 [95% CI 0.77-1.24]). Similar results were found for each individual DOAC as compared with warfarin (dabigatran: unadjusted OR 1.12 [95% CI 0.84-1.49], adjusted OR 0.96 [95% CI 0.71-1.30]); rivaroxaban: unadjusted OR 0.98 [95% CI 0.71-1.37], adjusted OR 0.84 [95% CI 0.59-1.21]; and apixaban: unadjusted OR 1.62 [95% CI 0.84-1.49], adjusted OR 1.22 [95% CI 0.83-1.79]).

CONCLUSIONS: Among patients admitted with gastrointestinal bleeding, there was no statistically significant difference in in-hospital mortality between prior use of DOAC and warfarin.

Original languageEnglish
JournalAmerican Heart Journal
Volume216
Pages (from-to)117-124
Number of pages8
ISSN0002-8703
DOIs
Publication statusE-pub ahead of print - 25 Jul 2019

ID: 58252351