Albumin and bleed risk in rivaroxaban treated patients.

Autor: Wojakowski E; University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY, 14642, USA.; Buffalo General Medical Center, 100 High Street, Buffalo, NY, 14203, USA., Cheruvil C; Upstate University Hospital, 750 East Adams Street, Syracuse, NY, 13210, USA.; University at Buffalo School of Pharmacy and Pharmaceutical Sciences, 205 Pharmacy Building, Buffalo, NY, 14214, USA., Hassan A; D'Youville School of Pharmacy, 320 Porter Avenue, Buffalo, NY, 14201, USA., Holsen MR; University at Buffalo School of Pharmacy and Pharmaceutical Sciences, 205 Pharmacy Building, Buffalo, NY, 14214, USA.; Buffalo General Medical Center, 100 High Street, Buffalo, NY, 14203, USA., Chen L; University at Buffalo School of Pharmacy and Pharmaceutical Sciences, 205 Pharmacy Building, Buffalo, NY, 14214, USA.; AdventHealth Celebration, 400 Celebration Place, Suite A110, Celebration, FL, 34747, USA., Rossi M; University at Buffalo School of Pharmacy and Pharmaceutical Sciences, 205 Pharmacy Building, Buffalo, NY, 14214, USA.; MedStar Union Memorial Hospital, 201 E University Pkwy, Baltimore, MD, 21218, USA., Wilcox N; University at Buffalo School of Pharmacy and Pharmaceutical Sciences, 205 Pharmacy Building, Buffalo, NY, 14214, USA., Woodruff AE; University at Buffalo School of Pharmacy and Pharmaceutical Sciences, 205 Pharmacy Building, Buffalo, NY, 14214, USA. aew7@buffalo.edu.; Buffalo General Medical Center, 100 High Street, Buffalo, NY, 14203, USA. aew7@buffalo.edu.
Jazyk: angličtina
Zdroj: Journal of thrombosis and thrombolysis [J Thromb Thrombolysis] 2020 Nov; Vol. 50 (4), pp. 1004-1011.
DOI: 10.1007/s11239-020-02092-w
Abstrakt: Drugs exhibiting high protein binding have potential increased action in patients with hypoalbuminemia. Rivaroxaban is 92-95% protein bound, but the clinical effects of rivaroxaban in patients with low albumin are largely unknown. The purpose of this study was to evaluate the relationship between albumin and bleeding in rivaroxaban treated patients. This was a retrospective cohort study of hospitalized adults who received rivaroxaban and had an albumin level measured during admission between January and October 2017. Patients who experienced bleeding events while receiving rivaroxaban therapy where compared to those who did not. A multivariable logistic regression model was used to evaluate the association between albumin levels and bleeding events. A total of 368 patients were included; 30 experienced a bleeding event and 338 did not. The mean ± standard deviation albumin level nearest to the time of rivaroxaban initiation was significantly lower in patients who experienced a bleeding event (3.0 ± 0.75 g/dL vs 3.66 ± 0.54 g/dL, p < 0.0001). The multivariable logistic regression model yielded an almost 4.5 fold higher risk of bleeding (adjusted odds ratio 4.405; 95% confidence interval 2.21-9) with any 1 g/dL reduction in albumin. Admission hemoglobin was also associated with bleed risk in the model. Albumin levels were significantly associated with bleed risk in patients receiving rivaroxaban. Albumin levels should be considered when evaluating candidates for rivaroxaban therapy.
Databáze: MEDLINE
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