Comparison of bleeding and ischemic events with apixaban vs. rivaroxaban in triple antithrombotic therapy regimens.

IF 1.2 4区 医学 Q4 HEMATOLOGY
Maya R Chilbert, Ashley E Woodruff, Marissa Saber, Pavel Goriacko, Mark Sinnet, David Jacobs
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引用次数: 0

Abstract

Objective: To compare the risk of readmissions for major bleeding within one year between apixaban and rivaroxaban as a component of triple antithrombotic therapy.

Methods: This study was a multicenter, retrospective cohort study conducted at two academic medical centers in the Western New York and New York City region between July 1, 2011 and September 25, 2019. Adult patients were included if they were diagnosed with atrial fibrillation or venous thromboembolism and discharged on new triple antithrombotic therapy. The primary outcome compared the rates of 1-year readmission for major bleeding between apixaban and rivaroxaban groups. Secondary outcomes included rate of ischemic outcomes. Time to event analysis was determined with a Kaplan-Meier plot and Cox proportional hazard ratios (HR).

Results: A total of 378 patients were included in the study, 212 in the apixaban group and 166 in the rivaroxaban group. Within 1 year, readmission for major bleeding events occurred in six (2.8%) patients in the apixaban group and four (2.4%) patients in the rivaroxaban group ( P  = 1.000). After adjustment, the major bleeding event rate was not statistically significantly different between apixaban and rivaroxaban [adjusted hazard ratio (aHR) 0.68, 95% confidence interval (CI) 0.12-3.77; P  = 0.6624]. Higher albumin levels were identified to be protective against major bleeding related readmission events (aHR 0.18, 95% CI 0.05-0.63; P  = 0.0072). The ischemic outcome occurred in seven (3.3%) patients in the apixaban group and three (1.8%) in the rivaroxaban group ( P  = 0.7368).

Conclusion: Use of apixaban or rivaroxaban in a triple antithrombotic regimen was not associated with bleeding or ischemic outcomes.

阿哌沙班与利伐沙班在三联抗血栓治疗方案中出血和缺血事件的比较。
目的:比较阿哌沙班和利伐沙班三联抗栓治疗一年内大出血再入院的风险。方法:本研究是一项多中心、回顾性队列研究,于2011年7月1日至2019年9月25日在纽约西部和纽约市地区的两个学术医疗中心进行。如果成年患者被诊断为房颤或静脉血栓栓塞,并接受新的三联抗血栓治疗出院,则纳入研究。主要结局比较阿哌沙班组和利伐沙班组1年大出血再入院率。次要结局包括缺血性结局的发生率。事件发生时间分析采用Kaplan-Meier图和Cox比例风险比(HR)确定。结果:共纳入378例患者,阿哌沙班组212例,利伐沙班组166例。1年内,阿哌沙班组有6例(2.8%)患者因大出血事件再入院,利伐沙班组有4例(2.4%)患者因大出血事件再入院(P = 1.000)。调整后,阿哌沙班与利伐沙班的大出血事件发生率差异无统计学意义[校正风险比(aHR) 0.68, 95%可信区间(CI) 0.12-3.77;P = 0.6624]。较高的白蛋白水平被认为对大出血相关的再入院事件有保护作用(aHR 0.18, 95% CI 0.05-0.63;P = 0.0072)。阿哌沙班组有7例(3.3%)患者出现缺血结局,利伐沙班组有3例(1.8%)患者出现缺血结局(P = 0.7368)。结论:在三联抗血栓治疗方案中使用阿哌沙班或利伐沙班与出血或缺血性结局无关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
1.90
自引率
0.00%
发文量
111
审稿时长
4-8 weeks
期刊介绍: Blood Coagulation & Fibrinolysis is an international fully refereed journal that features review and original research articles on all clinical, laboratory and experimental aspects of haemostasis and thrombosis. The journal is devoted to publishing significant developments worldwide in the field of blood coagulation, fibrinolysis, thrombosis, platelets and the kininogen-kinin system, as well as dealing with those aspects of blood rheology relevant to haemostasis and the effects of drugs on haemostatic components
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