title: Different risk factors for bleeding and discontinuation between dabigatran and rivaroxaban.
abstract: It is unclear whether risk factors for bleeding and discontinuation are different between dabigatran and rivaroxaban.
  
  
  
  We enrolled consecutive patients with atrial fibrillation who received dabigatran or rivaroxaban, had a CHADS2 score >1 and creatinine clearance >30ml/min. During this period, only dabigatran and rivaroxaban were available as non-vitamin K oral anticoagulants (NOACs) in our hospital. We compared the clinical and demographic data and the incidence of bleeding for one year between dabigatran group and rivaroxaban group. As a result, the dabigatran group consisted of 177 patients and the rivaroxaban group consisted of 179 patients. The incidence of discontinuation was significantly higher in the dabigatran group than in the rivaroxaban group (27.7% vs. 13.4%, p<0.001). Multivariate analysis, even after propensity score-matching analysis, revealed that there were no independent risk factors for bleeding in the dabigatran group, while in the rivaroxaban group, use of antiplatelet therapy was an independent factor correlating with bleeding.
  
  
  
  The risk factors for bleeding may be different between dabigatran and rivaroxaban. To avoid bleeding, rivaroxaban should be prescribed with caution or avoided in patients using antiplatelet therapy. Upon discontinuation, rivaroxaban may be more favorable than dabigatran.
authors.affiliation: Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan. Electronic address: mnishino@orh.go.jp.
authors.forename: Masami
authors.initials: M
authors.lastname: Nishino
authors.affiliation: Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan.
authors.forename: Naotaka
authors.initials: N
authors.lastname: Okamoto
authors.affiliation: Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Tanaka
authors.affiliation: Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Mori
authors.affiliation: Department of Cardiovascular Medicine and Medical Innovation, Osaka University Hospital, Suita, Osaka, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Hara
authors.affiliation: Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan.
authors.forename: Masamichi
authors.initials: M
authors.lastname: Yano
authors.affiliation: Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan.
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Makino
authors.affiliation: Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Egami
authors.affiliation: Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan.
authors.forename: Ryu
authors.initials: R
authors.lastname: Shutta
authors.affiliation: Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Tanouchi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000991:Antithrombins / Q000009:adverse effects*; D001281:Atrial Fibrillation / Q000188:drug therapy*; D000069604:Dabigatran / Q000009:adverse effects*; D057915:Drug Substitution; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006470:Hemorrhage / Q000139:chemically induced / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects; D057216:Propensity Score; D012307:Risk Factors; D000069552:Rivaroxaban / Q000009:adverse effects*; D016896:Treatment Outcome; D028761:Withholding Treatment
chemical_list: D000991:Antithrombins; D010975:Platelet Aggregation Inhibitors; D000069552:Rivaroxaban; D000069604:Dabigatran
keywords: Atrial fibrillation; Bleeding; Dabigatran; Non-vitamin K oral antagonists; Rivaroxaban