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Direct oral anticoagulants (DOACs) increase the risk for gastrointestinal bleeding (GIB). To identify risk differences among DOACs, investigators performed a retrospective, propensity-matched analysis of administrative claims data on more than 120 million privately insured Medicare Advantage enrollees.
Three matched-pair cohorts were created from 372,380 patients with nonvalve atrial fibrillation who were exposed to dabigatran, rivaroxaban, or apixaban during a period of 4 years and 5 months.
Results were as follows:
More GIB events occurred with rivaroxaban than with dabigatran (2.74 vs. 2.02/100 patient-years; hazard ratio, 1.20; 95% confidence interval, 1.00–1.45).
Fewer GIB events occurred with apixaban than with dabigatran (1.38 vs. 2.73/1…