{
    "abstract": "The efficacy and safety of direct oral anticoagulants (DOACs) in atrial fibrillation (AF) patients with impaired liver function (ILF) have not been sufficiently studied. The aim of this study was to evaluate the efficacy and safety of DOACs for stroke prevention in patients with AF and ILF.\nThis study was based on data from 15 centers in China, including 4,982 AF patients. The patients were divided into 2 subgroups based on their liver function status: patients with normal liver function (NLF)(n\u2009=\u20094213) and patients with ILF (n\u2009=\u2009769). Logistic regression analysis was used to investigate the risk of total bleeding, major bleeding, thromboembolism, and all-cause deaths in AF patients with NLF and ILF after taking dabigatran or rivaroxaban, respectively.\nAmong AF patients treated with dabigatran or rivaroxaban, patients with ILF were associated with significantly higher major bleeding, compared with NLF patients (aOR: 4.797; 95% CI: 2.224-10.256; P\u2009<\u20090.001). In patients with NLF, dabigatran (n\u2009=\u20092011) had considerably lower risk of total bleeding than rivaroxaban (n\u2009=\u20092202) (aOR: 1.23; 95% CI: 1.002-1.513; P\u2009=\u20090.049). In patients with ILF, dabigatran (n\u2009=\u2009321) significantly favored lower risks of major bleeding compared with rivaroxaban(n\u2009=\u2009448) (aOR: 5.484; 95% CI: 1.508-35.269; P\u2009=\u20090.026).\nAfter using dabigatran or rivaroxaban, patients with ILF had remarkably increased risk of major bleeding compared with patients with NLF. In AF patients with NLF, dabigatran had the distinct strength of significantly reduced risk of total bleeding compared with rivaroxaban. In patients with AF and ILF, dabigatran use was associated with lower risk for major bleeding compared with rivaroxaban.",
    "authors": [
        {
            "affiliation": "School of Pharmacy, Fujian Medical University, Fuzhou, China.\nDepartment of Pharmacy, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, #18 Daoshan Road, Fuzhou, 350001, China.",
            "firstname": "Xinhai",
            "initials": "X",
            "lastname": "Huang"
        },
        {
            "affiliation": "Department of Pharmacy, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, #18 Daoshan Road, Fuzhou, 350001, China.",
            "firstname": "Wenlin",
            "initials": "W",
            "lastname": "Xu"
        },
        {
            "affiliation": "School of Pharmacy, Fujian Medical University, Fuzhou, China.\nDepartment of Pharmacy, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, #18 Daoshan Road, Fuzhou, 350001, China.",
            "firstname": "Guilan",
            "initials": "G",
            "lastname": "Wu"
        },
        {
            "affiliation": "Department of Pharmacy, Tongji Shanxi Hospital, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China.",
            "firstname": "Ruijuan",
            "initials": "R",
            "lastname": "Li"
        },
        {
            "affiliation": "Department of Pharmacy, Suining Central Hospital, Suining, Sichuan, 629000, China.",
            "firstname": "Ping",
            "initials": "P",
            "lastname": "Gu"
        },
        {
            "affiliation": "Department of Pharmacy, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.",
            "firstname": "Qiaowei",
            "initials": "Q",
            "lastname": "Zheng"
        },
        {
            "affiliation": "Department of Pharmacy, People's Hospital of He'nan University of Chinese Medicine, People's Hospital of Zhengzhou), Zhengzhou, China.",
            "firstname": "Xiumei",
            "initials": "X",
            "lastname": "Liu"
        },
        {
            "affiliation": "Department of Pharmacy, Affiliated Fuzhou First Hospital of Fujian Medical University, Fuzhou, China.",
            "firstname": "Hengfen",
            "initials": "H",
            "lastname": "Dai"
        },
        {
            "affiliation": "Department of Pharmacy, Pingtan County General Laboratory Area Hospital, Fujian, China.",
            "firstname": "Xiangsheng",
            "initials": "X",
            "lastname": "Lin"
        },
        {
            "affiliation": "Department of Pharmacy, Huaihe Hospital of Henan University, kaifeng, China.",
            "firstname": "Yuxin",
            "initials": "Y",
            "lastname": "Liu"
        },
        {
            "affiliation": "Department of Pharmacy, Shengjing hospital of China Medical University, Shenyang, China.",
            "firstname": "Xiaoming",
            "initials": "X",
            "lastname": "Du"
        },
        {
            "affiliation": "Department of Pharmacy, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui Province, China.",
            "firstname": "Jun",
            "initials": "J",
            "lastname": "Su"
        },
        {
            "affiliation": "Department of Pharmacy, The first people's Hospital of Changde City, Changde, Hunan, China.",
            "firstname": "Wang",
            "initials": "W",
            "lastname": "Zhang"
        },
        {
            "affiliation": "Department of Pharmacy, Affiliated Qingdao Third People's Hospital, Qingdao University, Qingdao, Shandong, China.",
            "firstname": "Min",
            "initials": "M",
            "lastname": "Zhang"
        },
        {
            "affiliation": "Department of Pharmacy, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215004, China.",
            "firstname": "Zhu",
            "initials": "Z",
            "lastname": "Zhu"
        },
        {
            "affiliation": "Department of Pharmacy, Zhangzhou affiliated Hospital of Fujian Medical University, Zhangzhou, China.",
            "firstname": "Xiaohong",
            "initials": "X",
            "lastname": "Huang"
        },
        {
            "affiliation": "Department of Pharmacy, Taikang Tongji(Wuhan) Hospital, Wuhan, China.",
            "firstname": "Nianxu",
            "initials": "N",
            "lastname": "Huang"
        },
        {
            "affiliation": "Department of Pharmacy, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, #18 Daoshan Road, Fuzhou, 350001, China. pollyzhang2006@126.com.",
            "firstname": "Jinhua",
            "initials": "J",
            "lastname": "Zhang"
        }
    ],
    "conclusions": "After using dabigatran or rivaroxaban, patients with ILF had remarkably increased risk of major bleeding compared with patients with NLF. In AF patients with NLF, dabigatran had the distinct strength of significantly reduced risk of total bleeding compared with rivaroxaban. In patients with AF and ILF, dabigatran use was associated with lower risk for major bleeding compared with rivaroxaban.",
    "copyrights": "\u00a9 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.",
    "doi": "10.1007/s00228-024-03689-3\n10.1007/s10557-020-07065-y\n10.1161/CIRCULATIONAHA.113.005119\n10.2459/JCM.0b013e328358554b\n10.3390/pharmaceutics14061120\n10.3389/fcvm.2021.757087\n10.1016/j.jacc.2018.03.023\n10.1056/NEJMoa1107039\n10.1056/NEJMoa1310907\n10.1056/NEJMoa1302507\n10.1056/NEJMoa1306638\n10.1161/CIRCULATIONAHA.122.060687\n10.1093/ehjcvp/pvac063\n10.1161/STROKEAHA.116.016275\n10.1161/JAHA.118.009263\n10.1056/NEJMra1011170\n10.1182/asheducation-2015.1.243\n10.1378/chest.09-1584\n10.1378/chest.10-0134\n10.1111/j.1538-7836.2005.01204.x\n10.1093/eurheartj/ehw210\n10.1093/ehjcvp/pvab032\n10.1056/NEJMoa1009638\n10.1371/journal.pone.0144856\n10.1093/ehjcvp/pvz086\n10.1111/joim.12683\n10.1016/j.ijcard.2018.03.047\n10.1093/europace/euab065\n10.3390/jpm9010007\n10.1002/cpt.2369",
    "journal": "European journal of clinical pharmacology",
    "keywords": [
        "Atrial fibrillation",
        "Bleeding",
        "Direct oral anticoagulant",
        "Impaired liver function",
        "Thromboembolism"
    ],
    "methods": "This study was based on data from 15 centers in China, including 4,982 AF patients. The patients were divided into 2 subgroups based on their liver function status: patients with normal liver function (NLF)(n\u2009=\u20094213) and patients with ILF (n\u2009=\u2009769). Logistic regression analysis was used to investigate the risk of total bleeding, major bleeding, thromboembolism, and all-cause deaths in AF patients with NLF and ILF after taking dabigatran or rivaroxaban, respectively.",
    "publication_date": "2024-04-12",
    "pubmed_id": "38605248\n32880804\n24345399\n23114271\n35745692\n34881309\n29747837\n21870978\n24251359\n23808982\n23991658\n36762560\n36341531\n28213573\n30371232\n21751907\n19762550\n20299623\n15842354\n27567408\n33871577\n21830957\n26716830\n31942972\n28861925\n29934230\n33895845\n30658513\n34287842",
    "results": "Among AF patients treated with dabigatran or rivaroxaban, patients with ILF were associated with significantly higher major bleeding, compared with NLF patients (aOR: 4.797; 95% CI: 2.224-10.256; P\u2009<\u20090.001). In patients with NLF, dabigatran (n\u2009=\u20092011) had considerably lower risk of total bleeding than rivaroxaban (n\u2009=\u20092202) (aOR: 1.23; 95% CI: 1.002-1.513; P\u2009=\u20090.049). In patients with ILF, dabigatran (n\u2009=\u2009321) significantly favored lower risks of major bleeding compared with rivaroxaban(n\u2009=\u2009448) (aOR: 5.484; 95% CI: 1.508-35.269; P\u2009=\u20090.026).",
    "title": "Efficacy and safety of dabigatran and rivaroxaban in atrial fibrillation patients with impaired liver function: a multicenter retrospective cohort study.",
    "xml": "<Element 'PubmedArticle' at 0x7885038f89f0>"
}