Mortality associated with the use of non-vitamin K antagonist oral anticoagulants in cancer patients: Dabigatran versus rivaroxaban



Lin, Yu-Sheng, Kuan, Feng-Che, Chao, Tze-Fan, Wu, Michael, Chen, Shao-Wei, Chen, Mien-Cheng, Chung, Chang-Ming, Chu, Pao-Hsien, Lip, Gregory YH ORCID: 0000-0002-7566-1626 and Wu, Victor Chien-Chia
(2021) Mortality associated with the use of non-vitamin K antagonist oral anticoagulants in cancer patients: Dabigatran versus rivaroxaban. CANCER MEDICINE, 10 (20). pp. 7079-7088.

[img] PDF
Mortality associated with the use of non-vitamin K antagonist oral anticoagulants in cancer patients Dabigatran versus rivar.pdf - Open Access published version

Download (903kB) | Preview

Abstract

<h4>Objective</h4>This study assesses the mortality outcomes of non-vitamin K antagonist oral anticoagulants (NOACs) in cancer patients with venous thromboembolism (VTE) and atrial fibrillation (AF).<h4>Methods</h4>Medical records of cancer patients receiving NOACs for VTE or AF between January 1, 2011, and December 31, 2016, were retrieved from Taiwan's National Health Institute Research Database. NOACs were compared using the inverse probability of treatment weighting (IPTW) method. The primary outcome was cancer-related death. Secondary outcomes were all-cause mortality, major bleeding, and gastrointestinal (GI) bleeding.<h4>Results</h4>Among 202,754 patients who received anticoagulants, 3591 patients (dabigatran: 907; rivaroxaban: 2684) with active cancers were studied. Patients who received dabigatran were associated with lower risks of cancer-related death at one year (HR = 0.71, 95% CI = 0.54-0.93) and at the end of follow-ups (HR = 0.79, 95% CI = 0.64-0.98) compared with rivaroxaban. Patients who received dabigatran were also associated with lower risks of all-cause mortality (HR = 0.81, 95% CI = 0.67-0.97), major bleeding (HR = 0.64, 95% CI = 0.47-0.88), and GI bleeding (HR = 0.57, 95% CI = 0.39-0.84) at the end of follow-ups compared with rivaroxaban.<h4>Conclusion</h4>Compared with rivaroxaban, the use of dabigatran may be associated with a lower risk of cancer-related death and all-cause mortality.

Item Type: Article
Uncontrolled Keywords: atrial fibrillation, cancer, non-vitamin K antagonist oral anticoagulants, outcome, venous thromboembolism
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User: Symplectic Admin
Date Deposited: 13 Oct 2023 14:50
Last Modified: 13 Oct 2023 14:50
DOI: 10.1002/cam4.4241
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3173709