title: Risk of Gastrointestinal Bleeding with Rivaroxaban: A Comparative Study with Warfarin.
abstract: Introduction. The risk of gastrointestinal (GI) bleeding with rivaroxaban has not been studied extensively. The aim of our study was to assess this risk in comparison to warfarin. Methods. We examined the medical records for patients who were started on rivaroxaban or warfarin from April 2011 to April 2013. Results. We identified 300 patients (147 on rivaroxaban versus 153 on warfarin). GI bleeding occurred in 4.8% patients with rivaroxaban when compared to 9.8% patients in warfarin group (p = 0.094). GI bleeding occurred in 8% with therapeutic doses of rivaroxaban (>10 mg/d) compared to 9.8% with warfarin (p = 0.65). Multivariate analysis showed that patients who were on rivaroxaban for ≤40 days had a higher incidence of GI bleeding than those who were on it for >40 days (OR = 2.8, p = 0.023). Concomitant use of dual antiplatelet agents was associated with increased risk of GI bleeding in the rivaroxaban group (OR = 7.4, p = 0.0378). Prior GI bleeding was also a risk factor for GI bleeding in rivaroxaban group (OR = 15.5). Conclusion. The incidence of GI bleeding was similar between rivaroxaban and warfarin. The risk factors for GI bleeding with rivaroxaban were the first 40 days of taking the drug, concomitant dual antiplatelet agents, and prior GI bleeding.
authors.affiliation: Section of Gastroenterology and Hepatology, Georgia Regents University, 1120 15th Street, AD 2226, Augusta, GA 30912, USA.
authors.forename: Muhammed
authors.identifier: 0000-0001-7940-0362
authors.initials: M
authors.lastname: Sherid
authors.affiliation: Department of Internal Medicine, Froedtert Hospital and Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USA.
authors.forename: Samian
authors.identifier: 0000-0002-1303-6622
authors.initials: S
authors.lastname: Sulaiman
authors.affiliation: Department of Medicine, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, 251 East Huron Street, Suite 16-738, Chicago, IL 60611, USA.
authors.forename: Salih
authors.identifier: 0000-0003-1254-3670
authors.initials: S
authors.lastname: Samo
authors.affiliation: Department of Internal Medicine, Seton Hall University, School of Health and Medicine Sciences, Trinitas Regional Medical Center, 225 Williamson Street, Elizabeth, NJ 07202, USA.
authors.forename: Husein
authors.identifier: 0000-0002-4689-253X
authors.initials: H
authors.lastname: Husein
authors.affiliation: Department of Internal Medicine, Saint Francis Hospital, 355 Ridge Avenue, Evanston, IL 60202, USA.
authors.forename: Ruth
authors.initials: R
authors.lastname: Tupper
authors.affiliation: Section of Gastroenterology and Hepatology, Georgia Regents University, 1120 15th Street, AD 2226, Augusta, GA 30912, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Spurr
authors.affiliation: Section of Gastroenterology and Hepatology, Georgia Regents University, 1120 15th Street, AD 2226, Augusta, GA 30912, USA.
authors.forename: Humberto
authors.initials: H
authors.lastname: Sifuentes
authors.affiliation: Section of Gastroenterology and Hepatology, Georgia Regents University, 1120 15th Street, AD 2226, Augusta, GA 30912, USA.
authors.forename: Subbaramiah
authors.initials: S
authors.lastname: Sridhar