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Verfasst von:Darche, Fabrice Fernand [VerfasserIn]   i
 Fabricius, Lisa [VerfasserIn]   i
 Helmschrott, Matthias [VerfasserIn]   i
 Rahm, Ann-Kathrin [VerfasserIn]   i
 Ehlermann, Philipp [VerfasserIn]   i
 Bruckner, Thomas [VerfasserIn]   i
 Sommer, Wiebke [VerfasserIn]   i
 Warnecke, Gregor [VerfasserIn]   i
 Frey, Norbert [VerfasserIn]   i
 Rivinius, Rasmus [VerfasserIn]   i
Titel:Oral anticoagulants after heart transplantation - comparison between vitamin K antagonists and direct oral anticoagulants
Verf.angabe:Fabrice F. Darche, Lisa C. Fabricius, Matthias Helmschrott, Ann-Kathrin Rahm, Philipp Ehlermann, Tom Bruckner, Wiebke Sommer, Gregor Warnecke, Norbert Frey and Rasmus Rivinius
Jahr:2023
Umfang:14 S.
Illustrationen:Illustrationen
Fussnoten:Veröffentlicht: 28. Juni 2023 ; Gesehen am 18.08.2023
Titel Quelle:Enthalten in: Journal of Clinical Medicine
Ort Quelle:Basel : MDPI, 2012
Jahr Quelle:2023
Band/Heft Quelle:12(2023), 13, Artikel-ID 4334, Seite 1-14
ISSN Quelle:2077-0383
Abstract:Aims: Patients after heart transplantation (HTX) often require oral anticoagulants (OACs) due to atrial arrhythmias or thromboembolic events but little is known about the post-transplant use of direct oral anticoagulants (DOACs). We investigated the frequency, indications, and complications of DOACs and vitamin K antagonists (VKAs) after HTX. Methods: We screened all adult patients for the use of post-transplant OACs who underwent HTX at Heidelberg Heart Center between 2000 and 2021. Patients were stratified by type of OAC (DOAC or VKA) and by DOAC agents (apixaban, dabigatran, edoxaban, or rivaroxaban). Indications for OACs comprised atrial fibrillation, atrial flutter, pulmonary embolism, upper and lower extremity deep vein thrombosis, as well as intracardiac thrombus. Results: A total of 115 of 459 HTX recipients (25.1%) required OACs, including 60 patients with DOACs (52.2%) and 55 patients with VKAs (47.8%). Concerning DOACs, 28 patients were treated with rivaroxaban (46.7%), 27 patients with apixaban (45.0%), and 5 patients with edoxaban (8.3%). We found no significant differences between both groups concerning demographics, immunosuppressive drugs, concomitant medications, indications for OACs, ischemic stroke, thromboembolic events, or OAC-related death. Patients with DOACs after HTX had a significantly lower one-year rate of overall bleeding complications (p = 0.002) and a significantly lower one-year rate of gastrointestinal hemorrhage (p = 0.011) compared to patients with VKAs after HTX in the Kaplan-Meier estimator. Conclusions: DOACs were comparable to VKAs concerning the risk of ischemic stroke, thromboembolic events, or OAC-related death but were associated with significantly fewer bleeding complications in HTX recipients.
DOI:doi:10.3390/jcm12134334
URL:Bibliographic entry. University members only receive access to full-texts for open access or licensed publications.

kostenfrei: Volltext: https://doi.org/10.3390/jcm12134334
 kostenfrei: Volltext: https://www.mdpi.com/2077-0383/12/13/4334
 DOI: https://doi.org/10.3390/jcm12134334
Datenträger:Online-Ressource
Sprache:eng
Sach-SW:atrial fibrillation
 bleeding
 direct oral anticoagulant
 heart transplantation
 oral anticoagulant
 stroke
 vitamin K antagonist
K10plus-PPN:1856504093
Verknüpfungen:→ Journal

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