Warfarin hemorrhage risk
November 27, 2012
CANADIAN researchers have
determined that atrial fibrillation
patients are most likely to
hemorrhage in the first 30 days of
warfarin therapy, a finding which
has prompted calls for the Govt to
approve new oral anticoagulants,
such as Pradaxa, for the PBS.
The finding is part of a
population-based cohort study by
Canadian scientists published in the
Canadian Medical Association
Journal, which looked at 125,195
residents of Ontario aged over 66
years with atrial fibrillation who
started taking warfarin between
April 1997 and March 2008.
The researchers found that overall,
the rate of hemorrhage was 3.8%
per person-year, and that the risk of
a major hemorrhage was highest
during the first 30 days of treatment.
During this first 30 days, the rates
of hemorrhage were determined to
be 11.8% per person-year in all
patients and 16.7% per person-year
among patients with a CHADS2
(congestive heart failure,
hypertension, aged over 75 years,
diabetes mellitus and prior stroke,
transient ischemic attack or
thromboembolism) scores of 4 or
greater.
Over the five-year follow-up,
10,840 patients (8.7%) visited the
hospital for hemorrhage; of these
patients, 1,963 (18.1%) died in
hospital or within seven days of
being discharged.
In addition, over the five years,
5% of patients suffered intracranial
bleeding.
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