Impact of Novel Oral Anticoagulants On Gastrointestinal Safety and Outcomes in Patients With Atrial Fibrillation.

Abstract

Background: Oral anticoagulants (NOACs) is now the treatment of choice for atrial fibrillation (AF), with a number of benefits over traditional warfarin, including predictable pharmacokinetics and elimination of regular monitoring. Nonetheless, one more issue that affects clinical decision-making in relation to anticoagulant therapy is gastrointestinal (GI) safety, in particular, the risk of bleeding, which is a serious problem in AF patients.

Objectives: To find the effects of NOACs on the gastrointestinal safety and clinical outcome of patients with atrial fibrillation, and compare the safety and effectiveness of NOAC treatment with conventional warfarin-based treatment.

Methodology: This retrospective cohort study was carried out at Department of Medicine, LRH-MTI, Peshawar between jan 2020 to dec 2020.patients with AF who received NOAC treatment. Electronic health records were used to collect Descriptive statistics, t-tests, and chi-square were employed in the analysis of key outcomes such as incidence of GI bleeding, stroke prevention, and mortality rates. The demographics of the patients, the specifics of anticoagulant therapy, and GI complications were also noted. The p-value that was below 0.05 was taken to be statistically significant. The statistical analysis was conducted with the help of SPSS software.

Results: 100 patients the mean age was 74.3 years (SD = 7.6). Among them, 50 received apixaban, 30 received rivaroxaban, and 20 received dabigatran. The incidence of gastrointestinal bleeding was higher in rivaroxaban (8%) compared to apixaban (4%) and dabigatran (5%), with a significant p-value of 0.03 for rivaroxaban vs. apixaban. No significant differences were found in stroke incidence (2-3%) or mortality rates (1%) across the treatment groups.

Conclusion: This study has highlighted the significance of the use of proper NOAC depending on the gastrointestinal safety in atrial fibrillation patients. Apixaban has the best tradeoff between efficacy and safety, particularly with regard to gastrointestinal bleeding risk.