Comparaison de la sécurité et de l’efficacité des anticoagulants oraux durant les 6 premiers mois suivant l’instauration du traitement chez des patients atteints d’une fibrillation atriale

Abstract : Direct oral anticoagulants are now an alternative to anti-vitamin K (AVK). With VKA, there is an increased risk of haemorrhage during the months following the initiation of treatment. Objective : To compare the occurrence of major haemorrhagic events requiring hospitalization in patients with nonvalvular atrial fibrillation (FANV), treated with primary AVK or OAD prescription, for the first 6 months following initiation of treatment. Method : Cohort study, retrospective, comparative from the medico-administrative data of the Health Insurance during the period from June 2013 to June 2016 in the Auvergne region. Results : There were 2 times more hospitalizations for haemorrhage in the group of patients treated with AVK (75/2511 versus 41/2514, p> 0001). Thrombotic arterial events were more numerous in the AVK group (107 versus 62, p <0.001)). Patients treated with anti-platelet aggregators and men were more prone to haemorrhagic events. There was no difference between the groups for deaths from all causes. Serotonin and noradrenaline reuptake inhibitors appeared to be an increased risk of mortality. Conclusion : The data supports increased safety of use of OADs in anticoagulant-naive patients during the months following initiation of treatment. These results are consistent with data from other studies in real life, this in the French context of the preferential use of Fluindione, AVK very little studied in the literature. However, it must be taken into account that patients in the AVK group are at higher risk of bleeding because of a higher age.
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https://dumas.ccsd.cnrs.fr/dumas-02084063
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Noémie Martin. Comparaison de la sécurité et de l’efficacité des anticoagulants oraux durant les 6 premiers mois suivant l’instauration du traitement chez des patients atteints d’une fibrillation atriale. Sciences du Vivant [q-bio]. 2018. ⟨dumas-02084063⟩

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