An abstract titled, “Outcomes for Patients on DOACs in Compensated and Decompensated Cirrhosis,” was published in The American journal of Gastroenterology by authors Aysha Aslam, Saurabh Gombar, and Paul Kwo. Dr. Gombar is affiliated with Atropos Health, Dr. Aysha is affiliated with Stanford Health Care, and Dr. Kwo is affiliated with Stanford University School of Medicine. 

Short Summary:

Cirrhotic patients are prone to thromboembolism as well as bleeding. Use of novel anticoagulants is well established in patients with compensated cirrhosis and CTP class A patients however data on the efficacy and safety profile of DOACs in decompensated cirrhotic patients is limited. Our AIM was to determine if the clinical outcomes differed in those with compensated cirrhosis receiving DOACS (apixaban, rivaroxaban, edoxaban, and dabigatran) compared to those with decompensated cirrhosis in terms of thromboembolic events, atrial fibrillation (a fib), bleeding events, and TPA administration

Key Conclusions:

In a single site observational analysis we identified no difference in thrombotic events, a fib, bleeding, or administration of TPA when comparing compensated and decompensated liver cirrhosis patients who were on a DOAC. We matched patients on all baseline observable confounders at the time they began DOAC administration. For sensitivity analysis we stratified presenting MELD into low, medium, high and for each subgroup the findings were consistent.

Read the full abstract

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