Oral anticoagulants and risk of acute liver injury in patients with nonvalvular atrial fibrillation: a propensity-weighted nationwide cohort study.
Administration, Oral
Adolescent
Adult
Aged
Aged, 80 and over
Alcoholism
/ complications
Anticoagulants
/ adverse effects
Atrial Fibrillation
/ drug therapy
Cohort Studies
Dabigatran
/ administration & dosage
Female
France
Humans
Liver Failure, Acute
/ chemically induced
Male
Middle Aged
Propensity Score
Proportional Hazards Models
Pyrazoles
/ administration & dosage
Pyridones
/ administration & dosage
Risk
Rivaroxaban
/ administration & dosage
Young Adult
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
15 07 2020
15 07 2020
Historique:
received:
04
02
2020
accepted:
15
06
2020
entrez:
17
7
2020
pubmed:
17
7
2020
medline:
23
1
2021
Statut:
epublish
Résumé
Insufficient real-world data on acute liver injury (ALI) risk associated with oral anticoagulants (OACs) exist in patients with nonvalvular atrial fibrillation (NVAF). Using the French national healthcare databases, a propensity-weighted nationwide cohort study was performed in NVAF patients initiating OACs from 2011 to 2016, considering separately those (1) with no prior liver disease (PLD) as main population, (2) with PLD, (3) with a history of chronic alcoholism. A Cox proportional hazards model was used to estimate the hazard ratio with 95% confidence interval (HR [95% CI]) of serious ALI (hospitalised ALI or liver transplantation) during the first year of treatment, for each non-vitamin K antagonist (VKA) oral anticoagulant (NOAC: dabigatran, rivaroxaban, apixaban) versus VKA. In patients with no PLD (N = 434,015), only rivaroxaban new users were at increased risk of serious ALI compared to VKA initiation (adjusted HR: 1.41 [1.05-1.91]). In patients with chronic alcoholism history (N = 13,173), only those initiating dabigatran were at increased risk of serious ALI compared to VKA (2.88 [1.74-4.76]) but an ancillary outcome suggested that differential clinical follow-up between groups might partly explain this association. In conclusion, this study does not suggest an increase of the 1-year risk of ALI in NOAC versus VKA patients with AF.
Identifiants
pubmed: 32669591
doi: 10.1038/s41598-020-68304-8
pii: 10.1038/s41598-020-68304-8
pmc: PMC7363898
doi:
Substances chimiques
Anticoagulants
0
Pyrazoles
0
Pyridones
0
apixaban
3Z9Y7UWC1J
Rivaroxaban
9NDF7JZ4M3
Dabigatran
I0VM4M70GC
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
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