Comparison of vitamin K and non-vitamin K oral anticoagulants and the bleeding frequency in the emergency department.

IF 3.1 Q2 PERIPHERAL VASCULAR DISEASE High Blood Pressure & Cardiovascular Prevention Pub Date : 2024-01-01 Epub Date: 2024-01-08 DOI:10.1007/s40292-023-00616-y
Tomo Svaguša, Stjepan Šimić, Filip Grabant, Tatjana Kereš, Ognjen Čančarević, Frane Paić, Danijela Grizelj, Aleksandar Blivajs, Tomislav Bulum, Ingrid Prkačin
{"title":"Comparison of vitamin K and non-vitamin K oral anticoagulants and the bleeding frequency in the emergency department.","authors":"Tomo Svaguša, Stjepan Šimić, Filip Grabant, Tatjana Kereš, Ognjen Čančarević, Frane Paić, Danijela Grizelj, Aleksandar Blivajs, Tomislav Bulum, Ingrid Prkačin","doi":"10.1007/s40292-023-00616-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Safety studies of anticoagulant therapy have so far been conducted on many subjects in controlled conditions (i.e., clinically monitored) and demonstrated the noninferiority of new ones over old anticoagulant drugs. Data on the propositions for the presence of symptoms and signs of bleeding among various anticoagulants in the emergency department indicate that these data do not match the data published so far.</p><p><strong>Aim: </strong>The aim of the study was to investigate the differences in the frequency of bleeding and bleeding-related symptoms as a reason for emergency department attendance in patients on anticoagulant therapy.</p><p><strong>Methods: </strong>The study included patients from the emergency department of University Hospital for one year, who were on anticoagulant therapy and who met the inclusion criteria. Out of a total of 595 patients, 409 were on warfarin (68.74%), and the rest were taking direct oral anticoagulants (DOAC): dabigatran 71 (11.93%), rivaroxaban 66 (11.09%) and apixaban 49 (8.23%).</p><p><strong>Results: </strong>Out of 409 patients taking warfarin, 34.4% were adequately anticoagulated with the frequency of bleeding 13.7%, while in 57.2% of patients, PT INR was higher than the reference values with the frequency of bleeding 15.0%. A comparison between all DOAC groups and adequately anticoagulated warfarin patients in the frequency of bleeding and bleeding-related symptoms as a reason for emergency attendance yielded a difference that was marginally statistically significant (Pearson Chi-Square = 7.554, p = 0.052).</p><p><strong>Conclusion: </strong>Monitoring the frequency of bleeding and bleeding-related symptoms in patients on oral anticoagulant therapy as a reason for emergency department attendance may be a new safety and efficacy factor in real-life patient scenarios.</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":"23-30"},"PeriodicalIF":3.1000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"High Blood Pressure & Cardiovascular Prevention","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s40292-023-00616-y","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/8 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
引用次数: 0

Abstract

Introduction: Safety studies of anticoagulant therapy have so far been conducted on many subjects in controlled conditions (i.e., clinically monitored) and demonstrated the noninferiority of new ones over old anticoagulant drugs. Data on the propositions for the presence of symptoms and signs of bleeding among various anticoagulants in the emergency department indicate that these data do not match the data published so far.

Aim: The aim of the study was to investigate the differences in the frequency of bleeding and bleeding-related symptoms as a reason for emergency department attendance in patients on anticoagulant therapy.

Methods: The study included patients from the emergency department of University Hospital for one year, who were on anticoagulant therapy and who met the inclusion criteria. Out of a total of 595 patients, 409 were on warfarin (68.74%), and the rest were taking direct oral anticoagulants (DOAC): dabigatran 71 (11.93%), rivaroxaban 66 (11.09%) and apixaban 49 (8.23%).

Results: Out of 409 patients taking warfarin, 34.4% were adequately anticoagulated with the frequency of bleeding 13.7%, while in 57.2% of patients, PT INR was higher than the reference values with the frequency of bleeding 15.0%. A comparison between all DOAC groups and adequately anticoagulated warfarin patients in the frequency of bleeding and bleeding-related symptoms as a reason for emergency attendance yielded a difference that was marginally statistically significant (Pearson Chi-Square = 7.554, p = 0.052).

Conclusion: Monitoring the frequency of bleeding and bleeding-related symptoms in patients on oral anticoagulant therapy as a reason for emergency department attendance may be a new safety and efficacy factor in real-life patient scenarios.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
维生素 K 和非维生素 K 口服抗凝剂与急诊科出血频率的比较。
导言:迄今为止,已在受控条件下(即临床监测)对许多受试者进行了抗凝治疗安全性研究,结果表明新的抗凝药物并不优于旧的抗凝药物。关于各种抗凝药物在急诊科出现出血症状和体征的命题数据表明,这些数据与迄今为止公布的数据并不相符。研究目的:该研究旨在调查接受抗凝药物治疗的患者因出血和出血相关症状到急诊科就诊的频率差异:研究对象包括大学医院急诊科一年内符合纳入标准的抗凝治疗患者。在595名患者中,409人服用华法林(68.74%),其余患者服用直接口服抗凝剂(DOAC):达比加群71人(11.93%)、利伐沙班66人(11.09%)和阿哌沙班49人(8.23%):在409名服用华法林的患者中,34.4%的患者抗凝充分,出血频率为13.7%,而57.2%的患者PT INR高于参考值,出血频率为15.0%。所有 DOAC 组和充分抗凝的华法林患者在出血频率和作为急诊原因的出血相关症状方面的比较结果显示,两者之间的差异具有轻微的统计学意义(Pearson Chi-Square = 7.554,p = 0.052):结论:监测口服抗凝药患者出血和出血相关症状作为急诊就诊原因的频率,可能是现实生活中患者就诊的一个新的安全和疗效因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
CiteScore
5.70
自引率
3.30%
发文量
57
期刊介绍: High Blood Pressure & Cardiovascular Prevention promotes knowledge, update and discussion in the field of hypertension and cardiovascular disease prevention, by providing a regular programme of independent review articles covering key aspects of the management of hypertension and cardiovascular diseases. The journal includes:   Invited ''State of the Art'' reviews.  Expert commentaries on guidelines, major trials, technical advances.Presentation of new intervention trials design.''Pros and Cons'' or round tables on controversial issues.Statements on guidelines from hypertension and cardiovascular scientific societies.Socio-economic issues.Cost/benefit in prevention of cardiovascular diseases.Monitoring of healthcare systems.News and views from the Italian Society of Hypertension (including abstracts).All manuscripts are subject to peer review by international experts. Letters to the editor are welcomed and will be considered for publication.
期刊最新文献
Comparative Efficacy of Continuous Positive Airway Pressure and Antihypertensive Medications in Obstructive Sleep Apnea-Related Hypertension: A Narrative Review. Serum Uric Acid/Serum Creatinine Ratio and Chronic Vascular Lesions on Renal Biopsy: A Retrospective Observational Study. The Relationship Between Blood Pressure and Heart Rate Response During Exercise Testing with Microcirculation Indices. Independent Association of Individual Lipid Abnormalities with Cardiovascular All-cause Mortality: A Prospective Cohort Study. Prescriptive Appropriateness in an Outpatient Primary and Secondary Cardiovascular Prevention Service.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1