Assessing Major Bleeding Risk in Atrial Fibrillation Patients Concurrently Taking Non-Vitamin K Antagonist Oral Anticoagulants and Antiepileptic Drugs

European Heart Journal. Cardiovascular Pharmacotherapy
Chun-Li WangShang-Hung Chang

Abstract

This study compared the risk of major bleeding between atrial fibrillation (AF) patients who took non-vitamin-K antagonist oral anticoagulants (NOACs) and antiepileptic drugs (AEDs) concurrently and those who took only NOACs. We performed a retrospective cohort study using Taiwan National Health Insurance database and included AF patients who received NOAC prescriptions from June 1, 2012, to December 31, 2017. The major bleeding risks of person-quarters exposed to NOAC and 11 concurrent AEDs (carbamazepine, gabapentin, lamotrigine, levetiracetam, oxcarbazepine, phenobarbital, phenytoin, pregabalin, topiramate, valproic acid, and zonisamide) were compared with person-quarters exposed to NOAC alone. Adjusted incidence rate differences between NOAC with or without concurrent AEDs were estimated using Poisson regression models weighted by the inverse probability of treatment. Among 104319 patients (age 75.0±10.3 years; men, 56.2%), 8546 major bleeding events occurred during 731723 person-quarters with NOAC prescriptions. Concurrent AED use was found in 15.3% of NOAC-treated patients. Concurrent use of NOAC with valproic acid, phenytoin, or levetiracetam increased adjusted incidence rates per 1000 person-years of major bleeding more...Continue Reading

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Citations

Oct 9, 2019·European Heart Journal. Cardiovascular Pharmacotherapy·Joshua BrownGregory Y H Lip
Jul 6, 2020·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·M PumaV Di Piero
Apr 26, 2021·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Jan SteffelUNKNOWN External reviewers
Sep 22, 2021·European Heart Journal. Cardiovascular Pharmacotherapy

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