Study shows differences in bleeding risk among common blood thinners

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When patients are diagnosed with conditions such as blood clots or atrial fibrillation, they are often prescribed anticoagulants, also known as blood thinners, to prevent future clotting episodes.

However, a recent study compared three of the most commonly prescribed blood thinners and found significant differences in their associated bleeding risks.

The study focused on patients with blood clots or atrial fibrillation and investigated the oral anticoagulant rivaroxaban (marketed as Xarelto), apixaban (marketed as Eliquis), and the traditional blood thinner warfarin.

The research revealed that rivaroxaban was linked to a notably higher risk of bleeding complications compared to apixaban and warfarin.

These findings were presented at the 2023 American Society of Hematology’s Annual Meeting & Exposition and published in the journal Blood.

They were based on a comprehensive analysis of over ten years of patient data obtained from the Michigan Anticoagulation Quality Improvement Initiative registry, a multi-center initiative sponsored by Blue Cross Blue Shield of Michigan.

Dr. Jordan K. Schaefer, the first author of the study at the University of Michigan Medical School, explained, “We observed the highest rates of bleeding in patients who were prescribed rivaroxaban, followed by warfarin and then apixaban.

We followed these patients for over two years on average, allowing us to make comparisons between apixaban and rivaroxaban, which has not been done in a randomized clinical trial.

While further research is needed to confirm these findings through randomized studies, they can inform healthcare providers when selecting anticoagulants for their patients.”

According to the study’s analysis, for every 100 patients monitored over a year, rivaroxaban was associated with nearly 40 bleeding events, whereas warfarin had around 25 such events.

Bleeding events between apixaban and warfarin were similar, although warfarin was linked to more major bleeding episodes.

The study also noted that apixaban had a slightly higher rate of blood clots compared to warfarin. However, researchers suggested that this increase was primarily due to other thrombotic events, which included occurrences like heart attacks.

Among the three medications, apixaban was associated with a lower mortality rate compared to rivaroxaban and warfarin.

Dr. Geoffrey Barnes, the senior author of the study and an associate professor of cardiology-internal medicine at U-M Medical School, emphasized the importance of continuing research to better understand the effects of these commonly prescribed anticoagulants.

He noted that these findings could help guide healthcare providers in making informed decisions when selecting anticoagulants for their patients who have conditions like thrombosis and atrial fibrillation.

If you care about blood pressure, please read studies about Changing blood pressure readings is a hidden sign of heart disease and findings of Scientists shows switching blood pressure drugs may treat the condition better.

For more information about heart health, please see recent studies about new way to prevent heart attacks and strokes, and results showing this drug for heart disease may reduce COVID-19 risk.

The research findings can be found in Blood.

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