Risk of bleeding with factor Xa inhibitors versus unfractionated heparin in patients with acute kidney injury
© 2023 Pharmacotherapy Publications, Inc..
STUDY OBJECTIVE: To compare bleeding and thromboembolic events in patients receiving therapeutic doses of apixaban or rivaroxaban versus unfractionated heparin (UFH) in patients with acute kidney injury (AKI).
DESIGN: Single-center, retrospective, observational study.
SETTING: Ascension St. John Hospital in Detroit, Michigan.
PATIENTS: Hospitalized adult patients who received therapeutic doses of factor Xa inhibitors (n = 250) or UFH (n = 250) for at least 24 h in the setting of AKI.
MEASUREMENTS AND MAIN RESULTS: After adjusting for confounding factors, patients who received a factor Xa inhibitor experienced a lower risk of composite major and clinically relevant nonmajor bleeding (CRNMB) events compared with UFH (OR: 0.57, 95% CI: 0.34-0.94; p = 0.03). There was a significantly decreased risk of CRNMB events in the factor Xa inhibitor group (OR: 0.55, 95% CI: 0.33-0.91, p = 0.02); however, no significant differences in major bleeding or venous thromboembolism (VTE) were noted.
CONCLUSIONS: Our results suggest that it may be preferable to continue patients in AKI on factor Xa inhibitors versus transitioning to UFH due to the lower risk of bleeding events.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:43 |
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| Enthalten in: |
Pharmacotherapy - 43(2023), 2 vom: 15. Feb., Seite 129-135 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Aprilliano, Bianca [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 17.02.2023 Date Revised 06.03.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1002/phar.2759 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM350998094 |
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| 500 | |a Date Completed 17.02.2023 | ||
| 500 | |a Date Revised 06.03.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023 Pharmacotherapy Publications, Inc. | ||
| 520 | |a STUDY OBJECTIVE: To compare bleeding and thromboembolic events in patients receiving therapeutic doses of apixaban or rivaroxaban versus unfractionated heparin (UFH) in patients with acute kidney injury (AKI) | ||
| 520 | |a DESIGN: Single-center, retrospective, observational study | ||
| 520 | |a SETTING: Ascension St. John Hospital in Detroit, Michigan | ||
| 520 | |a PATIENTS: Hospitalized adult patients who received therapeutic doses of factor Xa inhibitors (n = 250) or UFH (n = 250) for at least 24 h in the setting of AKI | ||
| 520 | |a MEASUREMENTS AND MAIN RESULTS: After adjusting for confounding factors, patients who received a factor Xa inhibitor experienced a lower risk of composite major and clinically relevant nonmajor bleeding (CRNMB) events compared with UFH (OR: 0.57, 95% CI: 0.34-0.94; p = 0.03). There was a significantly decreased risk of CRNMB events in the factor Xa inhibitor group (OR: 0.55, 95% CI: 0.33-0.91, p = 0.02); however, no significant differences in major bleeding or venous thromboembolism (VTE) were noted | ||
| 520 | |a CONCLUSIONS: Our results suggest that it may be preferable to continue patients in AKI on factor Xa inhibitors versus transitioning to UFH due to the lower risk of bleeding events | ||
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a acute kidney injury | |
| 650 | 4 | |a apixaban | |
| 650 | 4 | |a rivaroxaban | |
| 650 | 4 | |a unfractionated heparin | |
| 650 | 7 | |a Heparin |2 NLM | |
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| 650 | 7 | |a Fibrinolytic Agents |2 NLM | |
| 650 | 7 | |a Anticoagulants |2 NLM | |
| 650 | 7 | |a Heparin, Low-Molecular-Weight |2 NLM | |
| 700 | 1 | |a Giuliano, Christopher |e verfasserin |4 aut | |
| 700 | 1 | |a Paxton, Renee Alexander |e verfasserin |4 aut | |
| 700 | 1 | |a Edwin, Stephanie B |e verfasserin |4 aut | |
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