Original Research
Sunday, October 13, 2024
12:45 PM–02:15 PM
Abstract
Introduction:
This study assesses the safety and efficacy of direct-acting oral anticoagulants (DOACs) in a predominantly obese population of kidney transplant recipients (KTR), who experience higher rates of venous thromboembolism (VTE) and atrial fibrillation (AFib) compared to the general population. Despite their common use for VTE and AFib treatment, limited studies describe DOAC use in KTR.
Research Question or Hypothesis: : Do KTR taking DOACs have a lower risk of bleeding events compared to those taking warfarin for AFib and/or VTEs?
Study Design: Single-center, retrospective study
Methods:
Adult KTR at the University of Illinois Health Hospital between 1/2018-8/2023 and were prescribed a DOAC or warfarin within 12 months post-transplant were included. Exclusions apply to those with mechanical or prosthetic valves, antiphospholipid syndrome, other anticoagulant indications, multi-organ transplants, pregnancy, or incarceration. The primary outcome is the composite of bleeding events. Secondary outcomes include major and minor bleeding, and VTE or stroke incidence. Outcomes were analyzed using descriptive, categorical, and continuous data, with a multivariate model to assess bleeding risk factors.
Results:
31 warfarin patients and 59 DOAC patients met criteria. The patients were predominantly Black (47.7%) and median BMI was 34 kg/m2. There was a difference in the reduction of composite in the DOAC group compared to the warfarin group (10.2% vs 32.3%; p=0.009). One thromboembolism event occurred in the warfarin group. The multivariate model demonstrated that having a surgery history (OR 0.27 (95% CI: 0.08-0.96; p=0.043) had an increased risk of developing a bleeding event.
Conclusion: DOACs significantly reduced bleeding events compared to warfarin, showed no difference in VTE incidence, and were effective in KTR. More studies are needed to support these findings.
Presenting Author
Emilio De La Rosa Gonzalez PharmDUniversity of Illinois at Chicago
Authors
Nancy Giang Student
University of Illinois at Chicago
Dana Pierce PharmD, BCTXP
University of Illinois at Chicago, College of Pharmacy