Using the Case-crossover Design to Assess Short-term Risks of Bleeding and Arterial Thromboembolism Following Switching Between Oral Anticoagulants in a Population-based Cohort of Atrial Fibrillation Patients.

Using the Case-crossover Design to Assess Short-term Risks of Bleeding and Arterial Thromboembolism Following Switching Between Oral Anticoagulants in a Population-based Cohort of Atrial Fibrillation Patients. Am J Epidemiol. 2020 Jul 08;: Authors: Hellfritzsch M, Wang SV, Grove EL, Gagne JJ, Hallas J, Pottegård A Abstract Using nationwide Danish registries, we conducted a population-based case-crossover study evaluating the association between switching from a vitamin K antagonist (VKA) to a direct oral anticoagulant (DOAC), and vice-versa, and 30-day risks of bleeding and arterial thromboembolism in atrial fibrillation (AF) patients. The case-crossover population was identified among oral anticoagulant users during 2011-2018 (n = 123,217), as AF patients with (a) a case-defining outcome and (b) an anticoagulant switch during the 180 days preceding the outcome. Odds Ratios were estimated using conditional logistic regression by comparing the occurrence of switching during the 30-day window immediately preceding the outcome to that in reference windows in the same individual 60-180 days before the outcome. The case-crossover populations for switching from VKA to DOAC and DOAC to VKA counted 1,382 and 287 cases, respectively. Switching from VKA to DOAC, but not from DOAC to VKA, was associated with an increased short-term risk of bleeding (Odds Ratio 1.42; 95%CI 1.13-1.79 and 1.06; 95%CI 0.64-1.75, respectively) and ischemic stroke...
Source: Am J Epidemiol - Category: Epidemiology Authors: Tags: Am J Epidemiol Source Type: research