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Observational studies suggest that rivaroxaban might confer higher risk for gastrointestinal (GI) bleeding than do other direct-acting oral anticoagulants (DOACs). Investigators used Iceland's nationwide prescription and electronic medical record databases to compare rates of GI bleeding among ≈5800 new users of apixaban, dabigatran, and rivaroxaban (55%, 37%, and 8% of cohort, respectively). Patients were followed for a mean 1.5 years; all diagnoses of GI bleeding were verified by medical record review. Patients with end-stage renal disease were excluded.
In propensity-score–matched analysis, patients who received rivaroxaban had significantly higher rates of GI bleeding (3.2% vs. 2.5% annually) and major GI bleeding (1.9% vs. 1.4% annually…