Efficacy and Safety of Direct Oral Anticoagulants in Patients With Atrial Fibrillation Combined With Hypertension: A Multi-Center, Retrospective Cohort Study.

Whether there are differences in direct oral anticoagulants efficacy and safety in patients with atrial fibrillation combined with hypertension are unclear. We therefore conducted a multicenter retrospective cohort study to assess the differences in efficacy and safety of direct oral anticoagulants in patients with atrial fibrillation combined with hypertension. This multi-center retrospective cohort study was based on data from 15 centers in China and included 2086 patients with atrial fibrillation. We divided the patients into dabigatran and rivaroxaban groups according to their direct oral anticoagulants. Propensity score matching was used to balance the covariates between the groups. Due to our limited sample size, the number of cases of some clinical events with low incidence was small. During a mean follow-up period of 10 months, a total of 268 (12.9%) bleeding events occurred, including 27 (1.3%) major bleeding events and 241 (11.6%) minor bleeding events, and 45 (2.2%) thromboembolic events. In atrial fibrillation patients combined with hypertension, rivaroxaban was associated with a higher major bleeding incidence than dabigatran (OR: 2.89; 95%Cl: 1.22-6.87; P:0.012). In contrast, the risk of thromboembolism and minor bleeding was similar for rivaroxaban and dabigatran (OR: 0.55; 95%Cl: 0.29-1.01; P: 0.069) (OR: 0.82; 95%Cl: 0.63-1.08; P: 0.150). Based on the results of this study, in patients with atrial fibrillation and hypertension treated with direct oral anticoagulants, the incidence of thromboembolism and minor bleeding was not statistically different between dabigatran and rivaroxaban, but compared with rivaroxaban, dabigatran was associated with a lower risk of major bleeding. This article is protected by copyright. All rights reserved.