AP-T: Comparison of direct oral anticoagulants and vitamin K antagonists in the risk of bleeding in the upper digestive tract

Huafarin is the only vitamin K antagonist in the country and has been a standard drug for decades for the treatment of acute venous thromboembolism, including deep vein thrombosis in the lower extremities and pulmonary embolism.
However, a number of new oral anticoagulants (or oral direct anticoagulants) have emerged in recent years, including Devasaban, Dabiga, Apixaban and Addosaban, which have become challengers to past standard programmes.
in order to compare the effects and side effects of new drugs and huafalin, this study analyzed the epidemiology and outcome of upper digestive tract bleeding (UGIB) caused by oral anticoagulant therapy.
, researchers conducted a forward-looking, multi-center study that included all UBIB patients who had occurred for a year in a row.
selected from the queue patients receiving oral anticoagulant therapy as a trial group.
outcomes are mortality and bleeding six weeks after UGIB, and the probability of requiring non-endoscopic treatment.
the study included 2,498 patients, 475 (19%) were treated with oral anticoagulants (DOAC), mostly vitamin K antagonists (VKA) (267 patients . . . 56.2%).
, with the exception of kidney failure and cirrhosis, which were more common in the VKA group, the baseline characteristics were similar between the groups.
gastroscopy was normal (15.3%) in 73 patients, and digestive lesions were the main cause of UBIB (n s 233,49%).
128 cases (26.9%) required endoscopic treatment, resulting in a 74% decline in bleeding (n s 95).
12.4% (59 patients) at 6 weeks of age, the mortality rate in the VKA group was higher than that of DOAC (16.1% VS 7.8%, P .lt;0.01).
multivarivariance analysis, only the Charlson index ≥5 and UGIB were independently associated with mortality.
(56 cases (11.8 per cent)) and the probability of requiring non-endoscopic treatment (18 cases (3.8 per cent)) were independent of the type of anticoagulant.
this study confirms that DOAC does not change the results of UGIB compared to VKA.
and related treatments are the most important factors that worsen UGIB prognosis.