{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T15:46:57Z","timestamp":1792597617508,"version":"4.5.0"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2024,12,25]],"date-time":"2024-12-25T00:00:00Z","timestamp":1735084800000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background and Aims<\/jats:title>\n                  <jats:p>Amiodarone is frequently prescribed alongside direct oral anticoagulants (DOACs) in atrial fibrillation. There are concerns regarding drug-drug interactions (DDIs) between amiodarone and DOACs. The literature is conflicting on the clinical implications of this DDI, hence we conducted a meta-analysis to compare bleeding risk among patients receiving DOACs, with and without concurrent amiodarone.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>A systematic search was conducted for studies published between 1 January 2009 and 26 June 2024 in MEDLINE via PubMed, Embase, and CENTRAL. Included studies compared major bleeding in patients on concurrent amiodarone and DOACs to those on DOACs without amiodarone. Event rates were used to calculate odds ratios (ORs), which were pooled with a random-effects model. Nine studies were identified, which included 124 813 patients on amiodarone\/DOACs, and 314 074 on DOACs. The average age was 77.2 years in the amiodarone\/DOAC group, compared to 74.4 years in the DOAC group (P\u00a0=\u00a00.21). Among DOAC patients, there was a statistically significant increase in major bleeding with concurrent amiodarone (OR 1.22, 95% confidence interval (CI) 1.03\u20131.44, P\u00a0=\u00a00.02, I2\u00a0=\u00a088%). Intracranial bleeding rate was numerically higher in the amiodarone\/DOAC group (1.0 vs. 0.4%), but the difference did not reach statistical significance (OR 2.20, 95% CI 0.53\u20139.06, P\u00a0=\u00a00.27, I2\u00a0=\u00a0100%). There were no significant differences in gastrointestinal bleeding (OR 1.10, 95% CI 0.98\u20131.23, P\u00a0=\u00a00.12, I2\u00a0=\u00a062%) and all-cause mortality (OR 1.38, 95% CI 0.70\u20132.73, P\u00a0=\u00a00.35, I2\u00a0=\u00a099%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Concurrent use of amiodarone and DOACs was associated with an increase in major bleeding. This should be considered when co-prescribing these medications.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcvp\/pvae097","type":"journal-article","created":{"date-parts":[[2024,12,25]],"date-time":"2024-12-25T03:35:44Z","timestamp":1735097744000},"page":"241-250","source":"Crossref","is-referenced-by-count":7,"title":["Risk of bleeding with the concurrent use of amiodarone and DOACs: a systematic review and meta-analysis"],"prefix":"10.1093","volume":"11","author":[{"given":"Faith","family":"Michael","sequence":"first","affiliation":[{"name":"Health Sciences North Department of Cardiology, , 41 Ramsey Lake Road, Sudbury, Ontario P3E 5J1 ,","place":["Canada"]},{"name":"Queen's University Department of General Internal Medicine, , Kingston, Ontario K7L 3N6,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Travis","family":"Quevillon","sequence":"additional","affiliation":[{"name":"Health Sciences North Department of Cardiology, , 41 Ramsey Lake Road, Sudbury, Ontario P3E 5J1 ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"Maisonneuve","sequence":"additional","affiliation":[{"name":"Health Sciences North Department of Cardiology, , 41 Ramsey Lake Road, Sudbury, Ontario P3E 5J1 ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia A","family":"Jackevicius","sequence":"additional","affiliation":[{"name":"Institute of Health Policy, Management and Evaluation, University of Toronto , Toronto, Ontario M5T 3M6,","place":["Canada"]},{"name":"ICES , Toronto and North, Ontario M4N 3M5,","place":["Canada"]},{"name":"College of Pharmacy, Western University of Health Sciences Department of Pharmacy Practice and Administration, , 309 E. 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Ontario M4N 3M5,","place":["Canada"]},{"name":"Division of Cardiology, Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto , Toronto, Ontario M4N 3M5,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2591-5111","authenticated-orcid":false,"given":"Mohammed","family":"Shurrab","sequence":"additional","affiliation":[{"name":"Health Sciences North Department of Cardiology, , 41 Ramsey Lake Road, Sudbury, Ontario P3E 5J1 ,","place":["Canada"]},{"name":"Institute of Health Policy, Management and Evaluation, University of Toronto , Toronto, Ontario M5T 3M6,","place":["Canada"]},{"name":"ICES , Toronto and North, Ontario M4N 3M5,","place":["Canada"]},{"name":"McMaster University wDivision of Cardiology, Department of Medicine, , Hamilton, Ontario V6T 1Z4,","place":["Canada"]},{"name":"Health Sciences North Research Institute , Sudbury, Ontario P3E 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