Background: The incidence of bleeding complications in patients with venous thromboembolism (VTE) on new oral anticoagulants (NOACs) has not been widely studied in contemporary practice in Africa.
Aims: To determine the rates of bleeding associated with NOAC use in daily clinical practice.
Methods: A retrospective review of adult patients diagnosed with venous thromboembolism and treated with NOACs at Aga Khan University Hospital from January 2014 to December 2019 was carried out. Clinical and outcome data were collected from medical records and the hospital mortality database. They were followed up from the time of commencement of oral anticoagulation to completion of therapy or to the time of the first clinically relevant non-major bleed (CRNM) or major bleed. Data on minor bleeding was also obtained. Data on bleeding was obtained from the hospital data base and through telephone interviews. Unadjusted rates of first major bleeding event or clinically relevant non-major bleeding (CRNM) was calculated as the number of bleeding events per 100 person-years
Results: 243 patients with VTE were recruited. 222(91.4%) were initiated on rivaroxaban, 12(4.9%) on dabigatran, 9(3.7%) on apixaban with a median follow-up of 213(119,477) days. The median age of the patients was 57(45, 71) years. A total of 64 bleeding events were identified in 41(16.9%) patients. Of all events, 18.8 % were major, 17.2 % were clinically relevant non-major (CRNM), and 64.1 % were minor. Overall, the incidence rate for bleeding events was 22.1 per 100 patient-years. Approximately 4% of all patients had a major bleeding event. Gastrointestinal bleeding was the most common major bleeding site. There were more females with bleeding events (70.7%) compared to males.
Conclusions: Most of these bleedings are minor with the GIT being the most common source of major bleeding and menorrhagia being the commonest cause of bleeding. Females had more major and clinically relevant non-major bleeds than men.
To cite this abstract in AMA style:Obayo A. Bleeding Complications in Patients on New Oral Anticoagulants for Venous Thromboembolism in Kenya [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/bleeding-complications-in-patients-on-new-oral-anticoagulants-for-venous-thromboembolism-in-kenya/. Accessed December 7, 2021.
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