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| Safety and Efficacy of the Use of Direct Oral Anticoagulants in Patients with a History of Bariatric Surgery |
| Nicholas Shabanowitz, Kayla Popova, Michelle Schultz, Nghi Ha Michigan Medicine, Ann Arbor, MI, United States |
Introduction Data in real-world use of direct oral anticoagulants (DOACs) in bariatric surgery patients is limited. The purpose of this study is to evaluate the safety and efficacy of DOACs in patients with a diagnosis of venous thromboembolism (VTE) or non-valvular atrial fibrillation (NVAF) and a history of bariatric surgery. Methods A retrospective matched case-cohort study of patients on a DOAC for the indication of VTE or NVAF and history of bariatric surgery compared to patients taking DOACs for the same indications but without a history of bariatric procedures. The efficacy outcomes were composite incidence of ischemic stroke, transient ischemic attack (TIA), VTE, and mortality from these events. Safety outcomes were composite incidence of clinically relevant non-major bleeding (CRNMB), major bleeding, and mortality from these events. Results A total of 110 cases and 110 controls were analyzed. There were no significant differences in incidence of VTE/TIA/CVA (4.6% vs. 3.6%, p = 0.73), composite bleeding (30% vs. 23.6%, p = 0.29), or major bleeding in cases vs. controls. CKD history was a statistically significant predictor for composite bleeding events (OR 2.2; p = 0.01 [1.16-4.04]). Conclusion There were no statistically significant differences in thrombotic or bleeding outcomes among patients on a DOAC with a history of bariatric surgery compared to those without a history of bariatric surgery. |