English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Zendy Plus

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Zendy Tools

Zendy Open

Summary   Background  Limited data are available about the real‐world safety of non‐vitamin K antagonist oral anticoagulants ( NOAC s).    Objectives  To compare the major bleeding risk among newly anticoagulated non‐valvular atrial fibrillation ( NVAF ) patients initiating apixaban, warfarin, dabigatran or rivaroxaban in the United States.    Methods and results  A retrospective cohort study was conducted to compare the major bleeding risk among newly anticoagulated  NVAF  patients initiating warfarin, apixaban, dabigatran or rivaroxaban. The study used the Truven MarketScan ®  Commercial &amp; Medicare supplemental  US  database from 1 January 2013 through 31 December 2013. Major bleeding was defined as bleeding requiring hospitalisation. Cox model estimated hazard ratios ( HR s) of major bleeding were adjusted for age, gender, baseline comorbidities and co‐medications. Among 29 338 newly anticoagulated  NVAF  patients, 2402 (8.19%) were on apixaban; 4173 (14.22%) on dabigatran; 10 050 (34.26%) on rivaroxaban; and 12 713 (43.33%) on warfarin. After adjusting for baseline characteristics, initiation on warfarin [adjusted  HR  ( aHR ): 1.93, 95% confidence interval ( CI ): 1.12–3.33,  P =.018] or rivaroxaban ( aHR : 2.19, 95%  CI : 1.26–3.79,  P =.005) had significantly greater risk of major bleeding vs  apixaban . Dabigatran initiation ( aHR : 1.71, 95%  CI : 0.94–3.10,  P =.079) had a non‐significant major bleeding risk vs apixaban.  When compared with warfarin , apixaban ( aHR : 0.52, 95%  CI : 0.30–0.89,  P =.018) had significantly lower major bleeding risk. Patients initiating rivaroxaban ( aHR : 1.13, 95%  CI : 0.91–1.41,  P =.262) or dabigatran ( aHR : 0.88, 95%  CI : 0.64–1.21,  P =.446) had a non‐significant major bleeding risk vs warfarin.    Conclusion  Among newly anticoagulated  NVAF  patients in the real‐world setting, initiation with rivaroxaban or warfarin was associated with a significantly greater risk of major bleeding compared with initiation on apixaban. When compared with warfarin, initiation with apixaban was associated with significantly lower risk of major bleeding. Additional observational studies are required to confirm these findings.

international journal of clinical practice

Major bleeding risk among non‐valvular atrial fibrillation patients initiated on apixaban, dabigatran, rivaroxaban or warfarin: a “real‐world” observational study in the United States