PMID- 36588500
OWN - NLM
STAT- MEDLINE
DCOM- 20230217
LR  - 20230306
IS  - 1875-9114 (Electronic)
IS  - 0277-0008 (Linking)
VI  - 43
IP  - 2
DP  - 2023 Feb
TI  - Risk of bleeding with factor Xa inhibitors versus unfractionated heparin in 
      patients with acute kidney injury.
PG  - 129-135
LID - 10.1002/phar.2759 [doi]
AB  - STUDY OBJECTIVE: To compare bleeding and thromboembolic events in patients 
      receiving therapeutic doses of apixaban or rivaroxaban versus unfractionated 
      heparin (UFH) in patients with acute kidney injury (AKI). DESIGN: Single-center, 
      retrospective, observational study. SETTING: Ascension St. John Hospital in 
      Detroit, Michigan. PATIENTS: Hospitalized adult patients who received therapeutic 
      doses of factor Xa inhibitors (n = 250) or UFH (n = 250) for at least 24 h in the 
      setting of AKI. MEASUREMENTS AND MAIN RESULTS: After adjusting for confounding 
      factors, patients who received a factor Xa inhibitor experienced a lower risk of 
      composite major and clinically relevant nonmajor bleeding (CRNMB) events compared 
      with UFH (OR: 0.57, 95% CI: 0.34-0.94; p = 0.03). There was a significantly 
      decreased risk of CRNMB events in the factor Xa inhibitor group (OR: 0.55, 95% 
      CI: 0.33-0.91, p = 0.02); however, no significant differences in major bleeding 
      or venous thromboembolism (VTE) were noted. CONCLUSIONS: Our results suggest that 
      it may be preferable to continue patients in AKI on factor Xa inhibitors versus 
      transitioning to UFH due to the lower risk of bleeding events.
CI  - (c) 2023 Pharmacotherapy Publications, Inc.
FAU - Aprilliano, Bianca
AU  - Aprilliano B
AD  - Department of Pharmacy, Ascension St. John Hospital, Detroit, Michigan, USA.
FAU - Giuliano, Christopher
AU  - Giuliano C
AD  - Department of Pharmacy, Ascension St. John Hospital, Detroit, Michigan, USA.
AD  - Department of Pharmacy, Wayne State University Eugene Applebaum Applebaum College 
      of Pharmacy and Health Sciences, Detroit, Michigan, USA.
FAU - Paxton, Renee Alexander
AU  - Paxton RA
AD  - Department of Pharmacy, Ascension St. John Hospital, Detroit, Michigan, USA.
FAU - Edwin, Stephanie B
AU  - Edwin SB
AUID- ORCID: 0000-0002-8175-372X
AD  - Department of Pharmacy, Ascension St. John Hospital, Detroit, Michigan, USA.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20230106
PL  - United States
TA  - Pharmacotherapy
JT  - Pharmacotherapy
JID - 8111305
RN  - 9005-49-6 (Heparin)
RN  - 0 (Factor Xa Inhibitors)
RN  - 0 (Fibrinolytic Agents)
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
SB  - IM
MH  - Adult
MH  - Humans
MH  - Heparin/adverse effects
MH  - Factor Xa Inhibitors/adverse effects
MH  - Retrospective Studies
MH  - Hemorrhage/chemically induced/epidemiology/drug therapy
MH  - *Venous Thromboembolism/drug therapy/chemically induced
MH  - Fibrinolytic Agents/therapeutic use
MH  - *Acute Kidney Injury/chemically induced
MH  - Anticoagulants/adverse effects
MH  - Heparin, Low-Molecular-Weight
OTO - NOTNLM
OT  - acute kidney injury
OT  - apixaban
OT  - rivaroxaban
OT  - unfractionated heparin
EDAT- 2023/01/03 06:00
MHDA- 2023/02/18 06:00
CRDT- 2023/01/02 03:23
PHST- 2022/12/12 00:00 [revised]
PHST- 2022/09/20 00:00 [received]
PHST- 2022/12/16 00:00 [accepted]
PHST- 2023/01/03 06:00 [pubmed]
PHST- 2023/02/18 06:00 [medline]
PHST- 2023/01/02 03:23 [entrez]
AID - 10.1002/phar.2759 [doi]
PST - ppublish
SO  - Pharmacotherapy. 2023 Feb;43(2):129-135. doi: 10.1002/phar.2759. Epub 2023 Jan 6.