Risk factors for anticoagulant-associated gastrointestinal hemorrhage: a systematic review and meta-analysis
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Background/Aims: There may be many predictors of anticoagulation-related gastrointestinal bleeding (GIB), but until now, systematic reviews and assessments of the certainty of the evidence have not been published. We conducted a systematic review to identify all risk factors for anticoagulant-associated GIB to inform risk prediction in the management of anticoagulation- related GIB. Methods: A systematic review and meta-analysis were conducted to search PubMed, EMBASE, Web of Science, and Cochrane Library databases (from inception through January 21, 2022) using the following search terms: anticoagulants, heparin, warfarin, dabigatran, rivaroxaban, apixaban, DOACs, gastrointestinal hemorrhage, risk factors. According to inclusion and exclusion criteria, studies of risk factors for anticoagulation-related GIB were identified. Risk factors for anticoagulant-associated GIB were used as the outcome index of this review. Results: We included 34 studies in our analysis. For anticoagulant-associated GIB, moderate-certainty evidence showed a probable association with older age, kidney disease, concomitant use of aspirin, concomitant use of the antiplatelet agent, heart failure, myocardial infarction, hematochezia, renal failure, coronary artery disease, helicobacter pylori infection, social risk factors, alcohol use, smoking, anemia, history of sleep apnea, chronic obstructive pulmonary disease, international normalized ratio (INR), obesity et al. Some of these factors are not included in current GIB risk prediction models. such as anemia, co-administration of gemfibrozil, co-administration of verapamil or diltiazem, INR, heart failure, myocardial infarction, etc. Conclusions: The study found that anemia, co-administration of gemfibrozil, co-administration of verapamil or diltiazem, INR, heart failure, myocardial infarction et al. were associated with anticoagulation-related GIB, and these factors were not in the existing prediction models. This study informs risk prediction for anticoagulant-associated GIB, it also informs guidelines for GIB prevention and future research.
Abstract
Background/Aims: There may be many predictors of anticoagulation-related gastrointestinal bleeding (GIB), but until now, systematic reviews and assessments of the certainty of the evidence have not been published. We conducted a systematic review to identify all risk factors for anticoagulant-associated GIB to inform risk prediction in the management of anticoagulation- related GIB. Methods: A systematic review and meta-analysis were conducted to search PubMed, EMBASE, Web of Science, and Cochrane Library databases (from inception through January 21, 2022) using the following search terms: anticoagulants, heparin, warfarin, dabigatran, rivaroxaban, apixaban, DOACs, gastrointestinal hemorrhage, risk factors. According to inclusion and exclusion criteria, studies of risk factors for anticoagulation-related GIB were identified. Risk factors for anticoagulant-associated GIB were used as the outcome index of this review. Results: We included 34 studies in our analysis. For anticoagulant-associated GIB, moderate-certainty evidence showed a probable association with older age, kidney disease, concomitant use of aspirin, concomitant use of the antiplatelet agent, heart failure, myocardial infarction, hematochezia, renal failure, coronary artery disease, helicobacter pylori infection, social risk factors, alcohol use, smoking, anemia, history of sleep apnea, chronic obstructive pulmonary disease, international normalized ratio (INR), obesity et al. Some of these factors are not included in current GIB risk prediction models. such as anemia, co-administration of gemfibrozil, co-administration of verapamil or diltiazem, INR, heart failure, myocardial infarction, etc. Conclusions: The study found that anemia, co-administration of gemfibrozil, co-administration of verapamil or diltiazem, INR, heart failure, myocardial infarction et al. were associated with anticoagulation-related GIB, and these factors were not in the existing prediction models. This study informs risk prediction for anticoagulant-associated GIB, it also informs guidelines for GIB prevention and future research.
참고문헌 (57)
- Hirsh J, "Antithrombotic and thrombolytic therapy : American College of Chest Physicians Evidence-Based Clinical Practice Guidelines(8th Edition)", Chest, 133(6 Suppl), pp.110S~112S (2008)
- Abraham NS, "Gastrointestinal safety of direct oral anticoagulants : a large population-based study", Gastroenterology, 152, pp.1014~1022 (2017)
- Jingke W, "Current status and progress of oral combination antithrombotic drug therapy", Int J Cardiovasc Dis, 44, pp.132~135 (2017)
- Choudari CP, "Acute gastrointestinal haemorrhage in patients treated with anticoagulant drugs", Gut, 36, pp.483~484 (1995)
- Rothberg MB, "Warfarin plus aspirin after myocardial infarction or the acute coronary syndrome : meta-analysis with estimates of risk and benefit", Ann Intern Med, 143, pp.241~250 (2005)
- Sørensen R, "Risk of bleeding in patients with acute myocardial infarction treated with different combinations of aspirin, clopidogrel, and vitamin K antagonists in Denmark : a retrospective analysis of nationwide registry data", Lancet, 374, pp.1967~1974 (2009)
- van Leerdam ME, "Acute upper GI bleeding: did anything change? Time trend analysis of incidence and outcome of acute upper GI bleeding between 1993", 1994 and 2000, 2003, pp.98, 1494~1499
- Hearnshaw SA, "Acute upper gastrointestinal bleeding in the UK : patient characteristics, diagnoses and outcomes in the 2007UK audit", Gut, 60, pp.1327~1335 (2011)
- Rosenstock SJ, "Improving quality of care in peptic ulcer bleeding : nationwide cohort study of 13, 498 consecutive patients in the Danish Clinical Register of Emergency Surgery", Am J Gastroenterol, 108, pp.1449~1457 (2013)
- Darzi AJ, "Prognostic factors for VTE and bleeding in hospitalized medical patients : a systematic review and meta-analysis", Blood, 135, pp.1788~1810 (2020)
- Riley RD, "A guide to systematic review and meta-analysis of prognostic factor studies", BMJ, 364, pp.k4597~ (2019)
- Liberati A, "The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions : explanation and elaboration", BMJ, 339, pp.b2700~ (2009)
- Tang SW, "Risk of bias assessment: (7) assessing bias in studies of prognostic factors", Zhonghua Liu Xing Bing Xue Za Zhi, 39, pp.1003~1008 (2018)
- Hayden JA, "Assessing bias in studies of prognostic factors", Ann Intern Med, 158, pp.280~286 (2013)
- Reeves BC, "Cochrane Handbook for Systematic Reviews of Interventions", pp.391~ (2008), Cochrane
- Iorio A, "Use of GRADE for assessment of evidence about prognosis : rating confidence in estimates of event rates in broad categories of patients", BMJ, 350, pp.h870~ (2015)
- Grant RL, "Converting an odds ratio to a range of plausible relative risks for better communication of research findings", BMJ, 348, pp.f7450~ (2014)
- Wang Z, "Converting odds ratio to relative risk in cohort studies with partial data information", J Stat Softw, 55, pp.1~11 (2013)
- Agudo-Fernández S, "RHEDAR study : determination of the risk of gastrointestinal hemorrhage in treatment with dabigatran, acenocoumarol and rivaroxaban", J Gastroenterol Hepatol, 36, pp.2794~2802 (2021)
- Fanning L, "Gastrointestinal bleeding risk with rivaroxaban vs aspirin in atrial fibrillation : a multinational study", Pharmacoepidemiol Drug Saf, 29, pp.1550~1561 (2020)
- Graham DJ, "Cardiovascular, bleeding, and mortality risks in elderly Medicare patients treated with dabigatran or warfarin for nonvalvular atrial fibrillation", Circulation, 131, pp.157~164 (2015)
- Aisenberg J, "Gastrointestinal bleeding with edoxaban versus warfarin : results from the ENGAGE AF-TIMI 48 trial(Effective Anticoagulation With Factor Xa Next Generation in Atrial Fibrillation-Thrombolysis In Myocardial Infarction)", Circ Cardiovasc Qual Outcomes, 11, pp.e003998~ (2018)
- Chan EW, "Prevention of dabigatran-related gastrointestinal bleeding with gastroprotective agents : a population-based study", Gastroenterology, 149, pp.586~595 (2015)
- Chen WC, "Gastrointestinal hemorrhage in warfarin anticoagulated patients : incidence, risk factor, management, and outcome", Biomed Res Int, 2014, pp.463767~ (2014)
- Coates J, "Clinical outcomes of dabigatran use in patients with non-valvular atrial fibrillation and weight >120 kg", Thromb Res, 208, pp.176~180 (2021)
- Delaney JA, "Drug drug interactions between antithrombotic medications and the risk of gastrointestinal bleeding", CMAJ, 177, pp.347~351 (2007)
- Douros A, "Concomitant use of direct oral anticoagulants with antiplatelet agents and the risk of major bleeding in patients with nonvalvular atrial fibrillation", Am J Med, 132, pp.191~199 (2019)
- Ferroni E, "Gender related differences in gastrointestinal bleeding with oral anticoagulation in atrial fibrillation", J Cardiovasc Pharmacol Ther, 27, pp.10742484211054609~ (2022)
- Gandhi SK, "Risk of major bleeding in patients with atrial fibrillation taking dronedarone in combination with a direct acting oral anticoagulant(from a U. S. Claims Database)", Am J Cardiol, 159, pp.79~86 (2021)
- Garcia DA, "Gastrointestinal bleeding in patients with atrial fibrillation treated with Apixaban or warfarin : insights from the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation(ARISTOTLE)trial", Am Heart J, 221, pp.1~8 (2020)
- Holm J, "Bleeding and thromboembolism due to drug-drug interactions with non-vitamin K antagonist oral anticoagulants-a Swedish, register-based cohort study in atrial fibrillation outpatients", Eur J Clin Pharmacol, 77, pp.409~419 (2021)
- Holt A, "Gastrointestinal bleeding risk following concomitant treatment with oral glucocorticoids in patients on non-vitamin K oral anticoagulants", Heart, 108, pp.626~632 (2022)
- Kato ET, "Efficacy and safety of edoxaban in elderly patients with atrial fibrillation in the ENGAGE AF-TIMI 48 trial", J Am Heart Assoc, 5, pp.e003432~ (2016)
- Kalil RS, "Association between renal function and bleeding risk for dabigatran after switching from warfarin", Am J Nephrol, 44, pp.11~18 (2016)
- Kolb JM, "Locations and mucosal lesions responsible for major gastrointestinal bleeding in patients on warfarin or dabigatran", Dig Dis Sci, 63, pp.1878~1889 (2018)
- Lauffenburger JC, "Predictors of gastrointestinal bleeding among patients with atrial fibrillation after initiating dabigatran therapy", Pharmacotherapy, 35, pp.560~568 (2015)
- Lee SR, "Body mass index and clinical outcomes in asian patients with atrial fibrillation receiving oral anticoagulation", Stroke, 52, pp.521~530 (2021)
- Leonard CE, "Gastrointestinal bleeding and intracranial hemorrhage in concomitant users of warfarin and antihyperlipidemics", Int J Cardiol, 228, pp.761~770 (2017)
- Maruyama K, "Difference between the upper and the lower gastrointestinal bleeding in patients taking nonvitamin K oral anticoagulants", Biomed Res Int, 2018, pp.7123607~ (2018)
- Murata N, "Gastrointestinal bleeding from oral anticoagulant therapy among Japanese patients with atrial fibrillation identified from the SAKURA atrial fibrillation registry", Circ J, 84, pp.1475~1482 (2020)
- Nantsupawat T, "Risk factors and prevention of dabigatran-related gastrointestinal bleeding in patients with atrial fibrillation", J Arrhythm, 34, pp.30~35 (2017)
- Nawarawong N, "Acute gastrointestinal bleeding in anticoagulated patients : prevalence and predictors of significant endoscopic lesions and change of the management", J Med Assoc Thai, 101, pp.135~ (2018)
- Olsen AS, "Risk of gastrointestinal bleeding associated with oral anticoagulation and non-steroidal anti-inflammatory drugs in patients with atrial fibrillation : a nationwide study", Eur Heart J Cardiovasc Pharmacother, 6, pp.292~300 (2020)
- Pham P, "Association of oral anticoagulants and verapamil or diltiazem with adverse bleeding events in patients with nonvalvular atrial fibrillation and normal kidney function", JAMA Netw Open, 3, pp.e203593~ (2020)
- Pourafkari L, "Upper gastrointestinal bleeding in the setting of excessive warfarin anticoagulation : risk factors, and clinical outcome", Cor et Vasa, 59, pp.e128~e133 (2017)
- Schauer DP, "Psychosocial risk factors for adverse outcomes in patients with nonvalvular atrial fibrillation receiving warfarin", J Gen Intern Med, 20, pp.1114~1119 (2005)
- Sherid M, "Gastrointestinal bleeding with dabigatran, a comparative study with warfarin : a multicenter experience", Korean J Gastroenterol, 65, pp.205~214 (2015)
- Sherid M, "Risk of gastrointestinal bleeding with dabigatran : a head-to-head comparative study with rivaroxaban", Digestion, 90, pp.137~146 (2014)
- Sherid M, "Risk of gastrointestinal bleeding with rivaroxaban : a comparative study with warfarin", Gastroenterol Res Pract, 2016, pp.9589036~ (2016)
- Sherwood MW, "Gastrointestinal bleeding in patients with atrial fibrillation treated with rivaroxaban or warfarin : ROCKET AF trial", J Am Coll Cardiol, 66, pp.2271~2281 (2015)
- Youn SH, "Effect of gastroprotective agents on upper gastrointestinal bleeding in patients receiving direct oral anticoagulants", Scand J Gastroenterol, 53, pp.1490~1495 (2018)
- Shimomura A, "New predictive model for acute gastrointestinal bleeding in patients taking oral anticoagulants : a cohort study", J Gastroenterol Hepatol, 33, pp.164~171 (2018)
- López-Jiménez L, "Venous thromboembolism in very elderly patients: findings from a prospective registry (RIETE)", Haematologica, 91, pp.1046~1051 (2006)
- Cuschieri JR, "Risk factors for acute gastrointestinal bleeding following myocardial infarction in veteran patients who are prescribed clopidogrel", J Dig Dis, 15, pp.195~201 (2014)
- de Groot NL, "Primary non-variceal upper gastrointestinal bleeding in NSAID and low-dose aspirin users : development and validation of risk scores for either medication in two large Dutch cohorts", J Gastroenterol, 49, pp.245~253 (2014)
- Xu W, "Severe bleeding risk of direct oral anticoagulants versus vitamin K antagonists for stroke prevention and treatment in patients with atrial fibrillation : a systematic review and network meta-analysis", Cardiovasc Drugs Ther, 37, pp.363~377 (2023)
- Ray WA, "Association of proton pump inhibitors with reduced risk of warfarin-related serious upper gastrointestinal bleeding", Gastroenterology, 151, pp.1105~1112 (2016)