Oral anticoagulants and risk of acute liver injury in patients with nonvalvular atrial fibrillation: a propensity-weighted nationwide cohort study
Autor: | Jérôme Drouin, Géric Maura, Anke Neumann, Cécile Billionnet, Marc Bardou, Alain Weill |
---|---|
Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
Male
Epidemiology medicine.medical_treatment Administration Oral lcsh:Medicine 030204 cardiovascular system & hematology Liver transplantation Cohort Studies 0302 clinical medicine Rivaroxaban Atrial Fibrillation 030212 general & internal medicine lcsh:Science Aged 80 and over education.field_of_study Multidisciplinary Hazard ratio Atrial fibrillation Middle Aged Dabigatran Alcoholism Apixaban Female France Cohort study medicine.drug Adult Risk medicine.medical_specialty Adolescent Pyridones Population Cardiology Article 03 medical and health sciences Young Adult Internal medicine medicine Humans education Propensity Score Aged Proportional Hazards Models Hepatology business.industry lcsh:R Anticoagulants Liver Failure Acute medicine.disease Pyrazoles lcsh:Q business |
Zdroj: | Scientific Reports, Vol 10, Iss 1, Pp 1-11 (2020) Scientific Reports |
ISSN: | 2045-2322 |
Popis: | Insufficient real-world data on acute liver injury (ALI) risk associated with oral anticoagulants (OACs) exist in patients with nonvalvular atrial fibrillation (NVAF). Using the French national healthcare databases, a propensity-weighted nationwide cohort study was performed in NVAF patients initiating OACs from 2011 to 2016, considering separately those (1) with no prior liver disease (PLD) as main population, (2) with PLD, (3) with a history of chronic alcoholism. A Cox proportional hazards model was used to estimate the hazard ratio with 95% confidence interval (HR [95% CI]) of serious ALI (hospitalised ALI or liver transplantation) during the first year of treatment, for each non-vitamin K antagonist (VKA) oral anticoagulant (NOAC: dabigatran, rivaroxaban, apixaban) versus VKA. In patients with no PLD (N = 434,015), only rivaroxaban new users were at increased risk of serious ALI compared to VKA initiation (adjusted HR: 1.41 [1.05–1.91]). In patients with chronic alcoholism history (N = 13,173), only those initiating dabigatran were at increased risk of serious ALI compared to VKA (2.88 [1.74–4.76]) but an ancillary outcome suggested that differential clinical follow-up between groups might partly explain this association. In conclusion, this study does not suggest an increase of the 1-year risk of ALI in NOAC versus VKA patients with AF. |
Databáze: | OpenAIRE |
Externí odkaz: | |
Nepřihlášeným uživatelům se plný text nezobrazuje | K zobrazení výsledku je třeba se přihlásit. |