British Journal of Clinical Pharmacology
Meta-analysis of 8 cohort studies suggest a slightly higher risk of gastrointestinal bleeding with dabigatran use compared with warfarin (risk ratio 1.21; 95% CI, 1.05-1.39), but no significant difference was found between rivaroxaban and warfarin.
Chest
Study (n=94,897) found direct oral anticoagulants (DOACs) had decreased risk for major bleeding vs vitamin K antagonists when estimated creatinine clearance (eCrCL) 50-80mL/min (RR 0.87, 95%CI 0.81-0.93). However, DOACs' bleeding risk differs from each other when eCrCL<50mL/min.
Circulation
Analysis (n=12,612) found among those with on-treatment worsening renal function, rivaroxaban (RV) was linked to lower rates of stroke/systemic embolism vs. warfarin, without increase in composite bleeding endpoint. This was not seen in patients with stable renal function on RV.
Two-year outcomes of patients with newly diagnosed atrial fibrillation: results from GARFIELD-AF
European Heart Journal
Two-year outcomes from ongoing, global observational study (n=17,162) found death was most frequent adverse outcome. Stroke-related mortality was not most frequent cause of death, suggesting that as well as anticoagulation, a more comprehensive approach to management is needed.
Biospace Inc.
Researchers have developed a new, free mobile app, "Aspirin-Guide" that calculates both the CVD risk score and the bleeding risk score for individual patients, and helps clinicians decide which patients are appropriate candidates for the use of low-dose aspirin (75 - 81mg daily).
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