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Incidence and characteristics of major bleeding among rivaroxaban users with renal disease and nonvalvular atrial fibrillation.

Publication ,  Journal Article
Patel, MR; Peacock, WF; Tamayo, S; Sicignano, N; Hopf, KP; Yuan, Z
Published in: Clin Exp Emerg Med
March 2018

OBJECTIVE: Patients with nonvalvular atrial fibrillation (AF) and renal disease (RD) who receive anticoagulation therapy appear to be at greater risk of major bleeding (MB) than AF patients without RD. As observed in past studies, anticoagulants are frequently withheld from AF patients with RD due to concerns regarding bleeding. The objective of this study was to evaluate the incidence and pattern of MB in those with RD, as compared to those without RD, in a population of rivaroxaban users with nonvalvular AF. METHODS: Electronic medical records of over 10 million patients from the Department of Defense Military Health System were queried to identify rivaroxaban users with nonvalvular AF. A validated algorithm was used to identify MB-related hospitalizations. RD was defined through diagnostic codes present within 6 months prior to the bleeding date for MB cases and end of study participation for non-MB patients. Data were collected on patient characteristics, comorbidities, MB management, and outcomes. RESULTS: Overall, 44,793 rivaroxaban users with nonvalvular AF were identified. RD was present among 6,921 patients (15.5%). Patients with RD had a higher rate of MB than those without RD, 4.52 per 100 person-years versus 2.54 per 100 person-years, respectively. The fatal bleeding outcome rate (0.09 per 100 person-years) was identical between those with and without RD. CONCLUSION: In this post-marketing study of 44,793 rivaroxaban users with nonvalvular AF, RD patients experienced a higher MB rate than those without RD. The higher rate of MB among those with RD may be due to the confounding effects of comorbidities.

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Published In

Clin Exp Emerg Med

DOI

ISSN

2383-4625

Publication Date

March 2018

Volume

5

Issue

1

Start / End Page

43 / 50

Location

Korea (South)
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Patel, M. R., Peacock, W. F., Tamayo, S., Sicignano, N., Hopf, K. P., & Yuan, Z. (2018). Incidence and characteristics of major bleeding among rivaroxaban users with renal disease and nonvalvular atrial fibrillation. Clin Exp Emerg Med, 5(1), 43–50. https://doi.org/10.15441/ceem.17.216
Patel, Manesh R., W Frank Peacock, Sally Tamayo, Nicholas Sicignano, Kathleen P. Hopf, and Zhong Yuan. “Incidence and characteristics of major bleeding among rivaroxaban users with renal disease and nonvalvular atrial fibrillation.Clin Exp Emerg Med 5, no. 1 (March 2018): 43–50. https://doi.org/10.15441/ceem.17.216.
Patel MR, Peacock WF, Tamayo S, Sicignano N, Hopf KP, Yuan Z. Incidence and characteristics of major bleeding among rivaroxaban users with renal disease and nonvalvular atrial fibrillation. Clin Exp Emerg Med. 2018 Mar;5(1):43–50.
Patel, Manesh R., et al. “Incidence and characteristics of major bleeding among rivaroxaban users with renal disease and nonvalvular atrial fibrillation.Clin Exp Emerg Med, vol. 5, no. 1, Mar. 2018, pp. 43–50. Pubmed, doi:10.15441/ceem.17.216.
Patel MR, Peacock WF, Tamayo S, Sicignano N, Hopf KP, Yuan Z. Incidence and characteristics of major bleeding among rivaroxaban users with renal disease and nonvalvular atrial fibrillation. Clin Exp Emerg Med. 2018 Mar;5(1):43–50.

Published In

Clin Exp Emerg Med

DOI

ISSN

2383-4625

Publication Date

March 2018

Volume

5

Issue

1

Start / End Page

43 / 50

Location

Korea (South)