Risk of bleeding between warfarin and dabigatran patients at Sultan Qaboos University hospital, Muscat, Oman : a retrospective analysis.
مؤلف
Ahmad, Sarah Gamal Elsheikh.
الملخص الإنجليزي
Aim; Warfarin has been the mainstay of therapy when oral anticoagulation is required. However, Side effects of warfarin have encouraged the development of alternative oral agents such as dabigatran, which is a reversible direct thrombin inhibitor. The aim of this study was to compare bleeding events between those on dabigatran and those on warfarin.
Method: This is a retrospective study conducted at Sultan Qaboos University Hospital (SQUH). It included 236 patients (with non-missing data) using dabigatran 110mg twice daily (n=111) and warfarin (n=125) between 2012 to 2014. Analysis was performed using univariate and multivariate statistics.
Results: The overall mean age of the cohort was 6611 ranging from 41 to 98 years of age and 51% were females. The most common indication for both drugs was atrial fibrillation (70%). And that the three most common bleeding types with both drugs were GIT bleeding (n=21), hematuria (n=14) and intracranial bleeding (n=9). Warfarin was more likely to be associated with gastrointestinal tract (GIT) bleeding than those on dabigatran (13% vs. 4.5%; p=0.026). The multivariate logistic model demonstrated that, adjusting for other risk factors, there were no significant differences in bleeding between warfarin and dabigaran 110 mg cohorts (adjusted odds ratio (OR) 0.58; 95%CI: 0.27-1.24; p=0.161). The only factor to be associated with bleeding was anticoagulation duration of therapy. Longer duration of anticoagulation therapy was associated with significantly higher incidence of bleeding (OR 1.04; 95%CI: 1.00 1.08; p=0.048).
Conclusion: The most frequent indication for both drugs was atrial fibrillation. After adjusting for other factors in the multivariate logistic model, there were no significant differences in bleeding between warfarin and dabigaran 110 mg users. The three most common bleeding types for both drugs were GIT bleeding, hematuria and nose bleed. Furthermore, the study also indicated that the duration of therapy was the only significant factor correlated with bleeding.
