Title :

Bleeding risk with rivaroxaban compared with vitamin K antagonists in patients aged 80 years or older with atrial fibrillation.

Author(s) :

Hanon, Olivier [Auteur]
Groupe hospitalier Broca
Vidal, Jean-Sébastien [Auteur]
AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris]
Pisica-Donose, Georges [Auteur]
Groupe hospitalier Broca
Orvoën, Galdric [Auteur]
AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris]
David, Jean-Philippe [Auteur]
Hôpital Henri Mondor
Chaussade, Edouard [Auteur]
AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris]
Caillard, Laure [Auteur]
Groupe hospitalier Broca
De Jong, Laura W. [Auteur]
Hôpital Sainte-Anne [Paris]
Boulloche, Nicolas [Auteur]
Centre hospitalier de Montauban [CH Montauban]
Vinsonneau, Ulric [Auteur]
Bouée, Stéphane [Auteur]
Krolak-Salmon, Pierre [Auteur]
Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center [CRNL]
Fauchier, Laurent [Auteur]
CHU Trousseau [Tours]
Jouanny, Pierre [Auteur]
Service de médecine gériatrique (CHU de Dijon - Centre gériatrique de Champmaillot - EHPAD)
Sacco, Guillaume [Auteur]
Centre Hospitalier Universitaire de Nice [CHU Nice]
Bellarbre, Fabienne [Auteur]
Centre hospitalier universitaire de Poitiers = Poitiers University Hospital [CHU de Poitiers [La Milétrie]]
Belmin, Joël [Auteur]
CHU Charles Foix [AP-HP]
Puisieux, Francois [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Lilamand, Matthieu [Auteur]
Optimisation thérapeutique en Neuropsychopharmacologie [OPTeN (UMR_S 1144 / U1144)]
Paillaud, Elena [Auteur]
Hôpital Européen Georges Pompidou [APHP] [HEGP]
Boureau, Anne Sophie [Auteur]
Centre Hospitalier Universitaire de Nantes = Nantes University Hospital [CHU Nantes]

Journal title :

Heart

Abbreviated title :

Heart

Publication date :

2020-12-08

ISSN :

1468-201X

English keyword(s) :

atrial fibrillation
epidemiology
pharmacology

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Objective Direct oral anticoagulants have been evaluated in the general population, but proper evidence for their safe use in the geriatric population is still missing. We compared the bleeding risk of a direct oral ...
Show more >Objective Direct oral anticoagulants have been evaluated in the general population, but proper evidence for their safe use in the geriatric population is still missing. We compared the bleeding risk of a direct oral anticoagulant (rivaroxaban) and vitamin K antagonists (VKAs) among French geriatric patients with non-valvular atrial fibrillation (AF) aged ≥80 years. Methods We performed a sequential observational prospective cohort study, using data from 33 geriatric centres. The sample comprised 908 patients newly initiated on VKAs between September 2011 and September 2014 and 995 patients newly initiated on rivaroxaban between September 2014 and September 2017. Patients were followed up for up to 12 months. One-year risks of major, intracerebral, gastrointestinal bleedings, ischaemic stroke and all-cause mortality were compared between rivaroxaban-treated and VKA-treated patients with propensity score matching and Cox models. Results Major bleeding risk was significantly lower in rivaroxaban-treated patients (7.4/100 patient-years) compared with VKA-treated patients (14.6/100 patient-years) after multivariate adjustment (HR 0.66; 95% CI 0.43 to 0.99) and in the propensity score–matched sample (HR 0.53; 95% CI 0.33 to 0.85). Intracerebral bleeding occurred less frequently in rivaroxaban-treated patients (1.3/100 patient-years) than in VKA-treated patients (4.0/100 patient-years), adjusted HR 0.59 (95% CI 0.24 to 1.44) and in the propensity score–matched sample HR 0.26 (95% CI 0.09 to 0.80). Major lower bleeding risk was largely driven by lower risk of intracerebral bleeding. Conclusions Our study findings indicate that bleeding risk, largely driven by lower risk of intracerebral bleeding, is lower with rivaroxaban than with VKA in stroke prevention in patients ≥80 years old with non-valvular AF.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
CHU Lille

Collections :

• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Submission date :

2023-11-15T07:42:16Z
2024-01-10T08:02:15Z
2024-01-10T08:10:31Z