ArticleClinical research in cardiology : official journal of the German Cardiac Society2020
Drug interactions with oral anticoagulants in German nursing home residents: comparison between vitamin K antagonists and non-vitamin K antagonist oral anticoagulants based on two nested case-control studies.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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11 citing papers in PubMed, 15 citations in OpenAlex.
- The Use of Direct Oral Anticoagulants (DOACs) in Older Adults Receiving Multidose Drug Dispensing; Interactions, Anticholinergic and Fall-Risk Increasing Drugs.Geriatrics (Basel, Switzerland) · 2026Article
- Concomitant Use of Selective Serotonin Reuptake Inhibitors With Oral Anticoagulants and Risk of Major Bleeding.JAMA network open · 2024Article
- Comparison of vitamin K and non-vitamin K oral anticoagulants and the bleeding frequency in the emergency department.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2024Article
- Impact of drug interactions with direct oral anticoagulants on mortality in elderly with atrial fibrillation during the COVID-19 pandemic.Medicina clinica (English ed.) · 2023Article
- Impact of drug interactions with direct oral anticoagulants on mortality in elderly with atrial fibrillation during the COVID-19 pandemic.Medicina clinica · 2023Article
- Swallowing and quality of life in individuals with Marfan syndrome: a cross-sectional study.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2022Article
- Comparison of potential pharmacokinetic drug interactions in patients with atrial fibrillation and changing from warfarin to non-vitamin K oral anticoagulant therapy.Journal of thrombosis and thrombolysis · 2021Article
- Anti-thrombotic strategies in patients with atrial fibrillation undergoing PCI.Clinical research in cardiology : official journal of the German Cardiac Society · 2021Review
- Clinical outcomes and thrombus resolution in patients with solid left atrial appendage thrombi: results of a single-center real-world registry.Clinical research in cardiology : official journal of the German Cardiac Society · 2021Article
- Concomitant Use of NSAIDs or SSRIs with NOACs Requires Monitoring for Bleeding.Yonsei medical journal · 2020Article
- Comparing the Prevalence of Polypharmacy and Potential Drug-Drug Interactions in Nursing Homes and in the Community Dwelling Elderly of Emilia Romagna Region.Frontiers in pharmacology · 2020Article
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundVitamin K antagonists (VKAs) are susceptible to drug-drug interactions. Non-VKA oral anticoagulants (NOACs) have a decreased sensitivity to pharmacokinetic interactions and might be therefore considered superior in patients treated with multiple drugs. The objective of this study was to compare the risk of serious bleeding associated with interacting drugs in German nursing home residents treated with VKA or NOAC.
methodsUsing claims data of new nursing home residents aged ≥ 65 years (2010-2014) we conducted separate nested case-control analyses within two cohorts of patients treated with VKA or NOAC, respectively. Cases were defined as patients hospitalized for serious bleeding. For each case, up to 20 controls were selected by risk-set sampling. Conditional logistic regression was used to obtain confounder-adjusted odds ratios (aORs) and 95% confidence intervals (CI) for the risk of bleeding associated with VKA or NOAC use and interacting drugs compared with the use of the respective oral anticoagulant alone.
resultsAmong 127,227 new nursing home residents, 16,804 patients received oral anticoagulation. Based on 372 cases and 7281 matched controls, the highest risk of bleeding in VKA users was observed for the concomitant use of antibiotics (aOR 3.00; CI 2.11-4.27) vs. VKA use alone, followed by non-steroidal anti-inflammatory drugs (1.66; 1.13-2.43). Among 243 NOAC cases and 4776 matched controls, elevated risks for bleeding were observed for the use of heparins (2.05; 1.25-3.36) and platelet inhibitors (1.92; 1.36-2.72).
conclusionsConcomitant medication needs to be prescribed cautiously and monitored closely in nursing home residents treated with oral anticoagulants.
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