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Different risk factors for bleeding and discontinuation between dabigatran and rivaroxaban

Masami Nishino1, Naotaka Okamoto1, Akihiro Tanaka1

  • 1Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan.

Journal of Cardiology
|October 8, 2015
PubMed

Insights

Discontinuation rates were higher for dabigatran compared to rivaroxaban. Rivaroxaban use with antiplatelet therapy requires caution due to bleeding risk factors.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Medicine

Background:

  • Uncertainty exists regarding differing risk factors for bleeding and discontinuation between dabigatran and rivaroxaban.
  • Non-vitamin K oral anticoagulants (NOACs) are crucial in managing atrial fibrillation.
  • Comparative studies are needed to guide clinical decisions.

Purpose of the Study:

  • To compare the incidence of bleeding and discontinuation between dabigatran and rivaroxaban in patients with atrial fibrillation.
  • To identify potential risk factors associated with bleeding for each anticoagulant.
  • To inform clinical practice regarding the use of these NOACs.

Main Methods:

  • Prospective enrollment of consecutive patients with atrial fibrillation receiving either dabigatran or rivaroxaban.
  • Inclusion criteria: CHADS2 score >1 and creatinine clearance >30ml/min.
  • One-year follow-up to compare clinical data, demographic data, and bleeding incidence.

Main Results:

  • The study included 177 patients on dabigatran and 179 on rivaroxaban.
  • Discontinuation rates were significantly higher in the dabigatran group (27.7%) versus the rivaroxaban group (13.4%).
  • Antiplatelet therapy was identified as an independent risk factor for bleeding in the rivaroxaban group, but not in the dabigatran group.

Conclusions:

  • Risk factors for bleeding may differ between dabigatran and rivaroxaban.
  • Rivaroxaban should be used cautiously or avoided in patients on antiplatelet therapy to mitigate bleeding risk.
  • Rivaroxaban appears more favorable than dabigatran concerning discontinuation rates.
Abstract

Keywords:
Atrial fibrillationBleedingDabigatranNon-vitamin K oral antagonistsRivaroxaban

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