Umeå University's logo

umu.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Bleeding risk in patients with venous thromboembolic events treated with new oral anticoagulants
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
2021 (English)In: Journal of Thrombosis and Thrombolysis, ISSN 0929-5305, E-ISSN 1573-742X, Vol. 52, no 1, p. 315-323Article in journal (Refereed) Published
Abstract [en]

New oral anticoagulants (NOACs) is the preferred treatment in secondary prophylaxis of venous thromboembolic events (VTE). The aim of this study was to investigate possible risk factors associated with major bleeding in VTE-patients treated with NOACs. In this retrospective register-based study we screened the Swedish anticoagulation register Auricula (during 2012.01.01-2017.12.31) to find patients and used other national registers for outcomes. Primary endpoint was major bleeding defined as bleeding leading to hospital care. Multivariate Cox-regression analysis was used to reveal risk factors. 18 219 patients with NOAC due to VTE were included. 85.6% had their first VTE, mean age was 69.4 years and median follow-up time was 183 days. The most common NOAC was rivaroxaban (54.8%), followed by apixaban (42.0%), dabigatran (3.2%) and edoxaban (0.1%). The rate of major bleeding was 6.62 (95% CI 6.19-7.06) per 100 treatment years in all patients and 11.27 (CI 9.96-12.57) in patients above 80 years of age. Statistically independent risk factors associated with major bleeding were age (normalized HR 1.38, CI 1.27-1.50), earlier major bleeding (HR 1.58, Cl 1.09-2.30), COPD (HR 1.28, CI 1.04-1.60) and previous stroke (HR 1.28, Cl 1.03-1.58) or transient ischemic attack (TIA) (HR 1.33, Cl 1.01-1.76). Prior warfarin treatment was protective (HR 0.67, CI 0.58-0.78). This real world cohort shows a high bleeding rate especially among the elderly and in patients with previous major bleeding, COPD and previous stroke or TIA. This should be considered when deciding on treatment duration and NOAC dose in these patients.

Place, publisher, year, edition, pages
Springer, 2021. Vol. 52, no 1, p. 315-323
Keywords [en]
New oral anticoagulants, Venous thromboembolism, Major bleeding, Risk factors
National Category
Hematology Cardiology and Cardiovascular Disease
Identifiers
URN: urn:nbn:se:umu:diva-176870DOI: 10.1007/s11239-020-02319-wISI: 000584370700001PubMedID: 33140837Scopus ID: 2-s2.0-85094925182OAI: oai:DiVA.org:umu-176870DiVA, id: diva2:1502243
Funder
Swedish Heart Lung Foundation, 20150435
Note

First published online: 2 November 2020

Available from: 2020-11-19 Created: 2020-11-19 Last updated: 2025-02-10Bibliographically approved

Open Access in DiVA

fulltext(640 kB)140 downloads
File information
File name FULLTEXT02.pdfFile size 640 kBChecksum SHA-512
0bbefdd6c0428c09f9b7992f09e38867675d6e77a0a973b72d386ae01489fa2a2e7d3d6be82c5ebaa5bb51154e1539f7c621e8cf3ab4e32bc857a48c79e7ffeb
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMedScopus

Authority records

Wange, NiklasSjälander, Anders

Search in DiVA

By author/editor
Wange, NiklasSjälander, Anders
By organisation
Section of Medicine
In the same journal
Journal of Thrombosis and Thrombolysis
HematologyCardiology and Cardiovascular Disease

Search outside of DiVA

GoogleGoogle Scholar
Total: 251 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 584 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf