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Sökning: WFRF:(Wallentin Lars C. 1943 ) > Locations and Mucos...

Locations and Mucosal Lesions Responsible for Major Gastrointestinal Bleeding in Patients on Warfarin or Dabigatran

Kolb, Jennifer M. (författare)
Univ Colorado Hosp, Dept Gastroenterol & Hepatol, Denver, CO USA
Flack, Kathryn Friedman (författare)
Hosp Univ Penn, Dept Internal Med, 3400 Spruce St, Philadelphia, PA 19104 USA
Chatterjee-Murphy, Prapti (författare)
Icahn Sch Med Mt Sinai, Dept Internal Med, New York, NY 10029 USA
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Desai, Jay (författare)
Icahn Sch Med Mt Sinai, Dept Gastroenterol & Hepatol, New York, NY 10029 USA
Wallentin, Lars C., 1943- (författare)
Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)
Ezekowitz, Michael (författare)
Thomas Jefferson Univ, Sidney Kimmel Med Coll, Philadelphia, PA 19107 USA
Connolly, Stuart (författare)
McMaster Univ, Populat Hlth Res Inst, Hamilton, ON, Canada;Hamilton Hlth Sci, Hamilton, ON, Canada
Reilly, Paul (författare)
Boehringer Ingelheim Pharmaceut, Ridgefield, CT USA
Brueckmann, Martina (författare)
Boehringer Ingelheim Int GmbH, Ingelheim, Germany;Heidelberg Univ, Fac Med Mannheim, Mannheim, Germany
Ilgenfritz, John (författare)
Ilgenfritz Consulting LLC, Conshohocken, PA USA
Aisenberg, James (författare)
Icahn Sch Med Mt Sinai, Dept Gastroenterol & Hepatol, New York, NY 10029 USA
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 (creator_code:org_t)
2018-03-27
2018
Engelska.
Ingår i: Digestive Diseases and Sciences. - : SPRINGER. - 0163-2116 .- 1573-2568. ; 63:7, s. 1878-1889
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • Different oral anticoagulants may be associated with gastrointestinal bleeding (GIB) from different locations or mucosal lesions. We aimed to test this hypothesis. Two blinded gastroenterologists independently analyzed source documents from the randomized evaluation of long-term anticoagulant therapy (RE-LY) trial of dabigatran 150 mg BID (D150), dabigatran 110 mg BID (D110) versus warfarin in non-valvular atrial fibrillation (NVAF). Major GIB events (total n = 546) and life-threatening GIB events (n = 258) were more common with D150 versus warfarin (RR 1.57 [1.28-1.92] and RR 1.62 [1.20-2.18], respectively) and similar for D110 compared to warfarin (RR 1.11 [0.89-1.38] and RR 1.16 [0.84-1.61], respectively). Fatal bleeding was similarly rare across treatment groups. Lower GI major bleeding and life-threatening bleeding were more common with D150 compared to warfarin (RR 2.23 [1.47, 3.38] and RR 2.64 [1.36, 5.13], respectively) and with D110 compared to warfarin (RR 1.78 [1.16, 2.75] and RR 2.00 [1.00, 4.00], respectively). MGIB from colonic angiodysplasia was increased with dabigatran versus warfarin (P < 0.01 for both dose comparisons). Subacute and chronic MGIB events were more common with D150 than with warfarin (RR 1.72 [1.06, 2.78] and RR 1.66 [1.12, 2.45], respectively), as were hematochezia or melena (RR 1.67 [1.18, 2.36] and RR 1.72 [1.20, 2.47], respectively). In a chronic NVAF population, D150 but not D110 is associated with increased major and life-threatening GI bleeding in comparison with warfarin. At both dabigatran doses, increased bleeding from the colorectum, in particular from angiodysplasia, is seen.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Nyckelord

Gastrointestinal bleeding
Gastrointestinal hemorrhage
Life-threatening gastrointestinal bleeding
Novel oral anticoagulants

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