Oral Anticoagulants’ Usage, Efficacy and Safety and their Association with Thrombosis and Bleeding Risks in Atrial Fibrillation Patients

SUMMARY. The study aimed to assess and compare efficacy and safety of oral anticoagulants (OACs) in atrial fibrillation (AF) patients and the risk of thrombosis and bleeding. This study also determined the effect of various demographic characteristics and comorbidities on the thrombosis and bleeding risks among AF patients. A single-center retrospective nonrandomized observational study was conducted on a cohort of oral anticoagulant atrial fibrillation patients treated with various OACs. From a public hospital, we identified 201 patients with AF initiating warfarin, dabigatran, rivaroxaban or apixaban for atrial fibrillation. We estimated one-year risks for major or clinically relevant non-major bleeding: intracranial, gastrointesti-nal, and other bleeding disorders. Overall, 201 patients were analyzed, of whom (n = 53; 26.36%), (n= 41; 20.39%), (n= 65; 32.33%), and (n = 42; 20.89%) initiated VKAs, apixaban, rivaroxaban, and dabigatran, respectively. According to the results obtained, warfarin 26.4%, dabigatran 31%, rivaroxaban 30.8%, and apixaban 19.5% caused bleeding risks among the studied cohort of the AF patients. All OACs were safe but varied in number of bleeding risks. Predictors of bleeding risks were age, hypertension, CrCl, ACS/CAD, and thrombocytopenia.