Title:Gastrointestinal Bleeding Associated With Warfarin and Rivaroxaban Therapy in Atrial Fibrillation Cases with Concomitant Coagulopathy
Volume: 21
Issue: 2
Author(s): Meghdad Sedaghat, Behnam Safarpour Lima, Reihanesadat Bouzari and Sarvenaz Shadlou*
Affiliation:
- Department of Internal Medicine, Shahid Beheshti University of Medical Sciences, Tehran,Iran
Keywords:
Atrial fibrillation, treatment, gastrointestinal bleeding, coagulopathy, rivaroxaban, hypertension.
Abstract:
Background: There is inadequate information on the risk of gastrointestinal (GI) bleeding
in patients who are under rivaroxaban and warfarin therapy in Iran. Determining the risk of GI
bleeding in patients receiving these two drugs can help to select a more appropriate anti-coagulation
prophylaxis in high-risk patients.
Objective: The aim of this study was to compare the incidence of GI bleeding in patients with atrial
fibrillation (AF) and concomitant bleeding risk factors receiving either warfarin or rivaroxaban.
Methods: In this observational study, 200 patients with AF and bleeding risk factors who referred
to Imam Hossein Hospital (Tehran, Iran) were included. The patients were under treatment with either
warfarin or rivaroxaban. The incidence of GI bleeding was compared between the two groups
monthly for one year.
Results: GI bleedings were observed in 61% and 34% of patients treated with warfarin and rivaroxaban,
respectively (P = 0.001).Melena was the most common type of GI bleeding in both groups.
History of hypertension, history of stroke, consumption of anti-platelet drugs, NSAID consumption,
and history of alcohol consumption were associated with more frequent GI bleeding only in
warfarin group.
Conclusion: The incidence of GI bleeding was lower in AF patients who received rivaroxaban
compared to those treated with warfarin. Also, GI bleeding risk does not change according to the
consumption of other anti-coagulant drugs and underlying history of hypertension or stroke in patients
received rivaroxaban. Therefore, rivaroxaban is suggested as the choice of prophylaxisin patients
with AF and concomitant coagulopathy.
