Gastrointestinal Bleeding Risk with Warfarin vs. Non–Vitamin K–Dependent Direct Oral Anticoagulants

Study results are mixed on the comparative risk for gastrointestinal bleeding (GIB) associated with use of non–vitamin K–dependent direct oral anticoagulants (DOACs) versus warfarin. In the current retrospective study, investigators at a U.S. Veterans Administration healthcare center compared hospitalization rates for GIB in 803 patients taking DOACs (dabigatran, rivaroxaban, or apixaban) and 6263 patients taking warfarin.

Results were as follows:

• GIB incidence was four times higher in warfarin users (2.5% vs. 0.6%).

• DOAC users were more likely to have a venous thrombosis or pulmonary embolus as their indication for anticoagulation and to have a lower comorbidity index (trends not statistically significant).

• Sources of GIB in the five affected …