Abstract
To investigate the incidence of bleeding events in atrial fibrillation (AF) patients treated with vitamin K (VKAs) or non-vitamin K antagonist oral anticoagulants (NOACs) screened for the presence of liver fibrosis (LF). Previous studies provided conflicting results on bleeding risk in AF patients with liver disease on VKAs, and no data on NOACs in this setting are available. Post-hoc analysis of a prospective, observational multicentre study including 2330 AF outpatients treated with VKAs (n = 1297) or NOACs (n = 1033). Liver damage was quantified by the FIB-4 score (>3.25), a validated marker of LF. The primary endpoint was the incidence of any bleeding, according to ISTH classification. A high FIB-4 was present in 129 (5.5%) patients: 77 (5.9%) on VKA and 52 (5.0%) on NOACs (p = 0.344). During follow-up, 357 (15.3%) patients experienced a bleeding: 261 (80 major and 180 minor) with VKAs (7.2%/year), and 96 (40 major and 56 minor) with NOACs (6.4%/year). In VKA-treated patients, but not in those on NOACs, FIB-4 >3.25 was associated with higher major bleeding (14.3% vs. 5.6%, log-rank test p < 0.001). Multivariable Cox regression model showed that FIB-4 was associated with major bleeding only in VKA-treated patients (HR: 3.075...Continue Reading
Citations
Nov 20, 2018·European Journal of Gastroenterology & Hepatology·Ronpichai ChokesuwattanaskulWisit Cheungpasitporn
Sep 6, 2019·American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions·Yonghui FuWenfeng He
May 10, 2020·British Journal of Clinical Pharmacology·Daniele PastoriVito Menafra
Aug 30, 2020·European Heart Journal·Gerhard HindricksUNKNOWN ESC Scientific Document Group
Sep 9, 2020·European Journal of Clinical Investigation·Danilo MenichelliUNKNOWN CAR
Sep 12, 2018·Therapeutic Advances in Gastroenterology·Stefania BasiliFrancesco Violi
Oct 3, 2018·Internal and Emergency Medicine·Domenico PriscoFrancesco Perticone
Jan 8, 2020·Stroke; a Journal of Cerebral Circulation·Neal S ParikhUNKNOWN VISTA-ICH Collaborators
Feb 27, 2020·Journal of Clinical Medicine·Yuki SaitoAtsushi Hirayama
Apr 15, 2020·Advances in Therapy·Stefano BallestriGiorgio Cioni
Sep 12, 2020·World Journal of Clinical Cases·Jie-Min ChenJun Lan
Mar 28, 2019·Frontiers in Cardiovascular Medicine·Daniele PastoriFrancesco Violi
Apr 16, 2019·Therapeutic Advances in Gastroenterology·Michelle T LongRobert H Helm
Jun 20, 2020·Clinical Cardiology·Qixin DaiYonghui Liao
Jul 7, 2020·Hepatology Communications·Francesco VioliPasquale Pignatelli
Aug 21, 2020·Seminars in Thrombosis and Hemostasis·Matthew J StottsNicolas M Intagliata
Oct 20, 2020·Internal and Emergency Medicine·Francesco VioliDaniele Pastori
Apr 9, 2020·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Marina SerperDavid E Kaplan
Mar 25, 2019·Current Problems in Cardiology·Danilo MenichelliDaniele Pastori
Mar 18, 2021·Journal of Thrombosis and Thrombolysis·Sarah A NislyJanine Tillett
Apr 20, 2021·European Heart Journal. Cardiovascular Pharmacotherapy·Shaojie ChenBoris Schmidt
Jul 1, 2021·International Journal of Clinical Practice·Taomin SuDongfeng Guo
Jul 15, 2021·European Journal of Haematology·Hannah Stowe McMurryJoseph Shatzel
Aug 18, 2021·Current Opinion in Pharmacology·Costanza De MariaAndrea De Gottardi
Sep 29, 2021·Gastroenterology·Nicolas M IntagliataJonathan G Stine
Jan 9, 2022·Scientific Reports·Min KimBoyoung Joung