Choosing Anticoagulants for Patients with Atrial Fibrillation and Previous Gastrointestinal Bleeding

Direct-acting oral anticoagulants seem to be safer in this study of Asian patients.

Most patients with atrial fibrillation (AF) require oral anticoagulants for long-term stroke prevention. The existence of a previous gastrointestinal (GI) bleeding episode adds complexity to the choice of medication. Little information exists on direct-acting oral anticoagulants (DOACs) relative to warfarin for this patient subgroup. In a manufacturer-supported study, researchers examined a large national database from South Korea to identify 42,048 patients with AF and a GI bleed preceding anticoagulation treatment (mean age, 72; 57% men). Major outcomes of interest were ischemic stroke, major bleeding, and a composite of the two.

Patients' mean CHA₂DS₂-VASc score was 3.7, and almost one third had a prior stroke. The mean time from prior GI…

Reviewing Author

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Choosing Anticoagulants for Patients with Atrial Fibrillation and Previous Gastrointestinal Bleeding

Topics

Reviewing Author