{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T08:39:47Z","timestamp":1789893587100,"version":"4.0.1"},"reference-count":24,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,3,13]],"date-time":"2018-03-13T00:00:00Z","timestamp":1520899200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"New York State Council of Health-system Pharmacists"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>A complication of chronic liver disease (<jats:styled-content style=\"fixed-case\">CLD<\/jats:styled-content>) is the abnormality of coagulation. In clinical practice, this increased risk of bleeding has not been identified as a protective factor against stroke or systemic embolism associated with atrial fibrillation (<jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>). The objective of this study was to assess the safety of direct oral anticoagulant (<jats:styled-content style=\"fixed-case\">DOAC<\/jats:styled-content>) agents vs warfarin in <jats:styled-content style=\"fixed-case\">CLD<\/jats:styled-content> patients with <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective cohort study of patients with <jats:styled-content style=\"fixed-case\">CLD<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content> initiated on oral anticoagulants. Rates of all\u2010cause bleeding were compared between warfarin and <jats:styled-content style=\"fixed-case\">DOAC<\/jats:styled-content> agents. Secondary endpoints included rates of major bleeding and other risk factors for bleeding on anticoagulant therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The all\u2010cause bleeding rates were similar between the groups, with 8.4% per year in the <jats:styled-content style=\"fixed-case\">DOAC<\/jats:styled-content> (n\u00a0=\u00a075) group and 8.8% in warfarin (n\u00a0=\u00a0158) group (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> 0.9, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.4\u20101.8). No significant difference was noted in the rate of major bleeding. In the multivariable model, higher <jats:styled-content style=\"fixed-case\">MELD<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">XI<\/jats:styled-content> score and previous bleed were risk factors associated with increased bleeding.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>No significant differences in bleeding rates were noted in patients treated with warfarin and <jats:styled-content style=\"fixed-case\">DOAC<\/jats:styled-content> agents. Further studies evaluating <jats:styled-content style=\"fixed-case\">DOAC<\/jats:styled-content> agents are needed to better understand the optimal anticoagulation strategy in setting of <jats:styled-content style=\"fixed-case\">CLD<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ejh.13045","type":"journal-article","created":{"date-parts":[[2018,2,14]],"date-time":"2018-02-14T18:46:40Z","timestamp":1518634000000},"page":"488-493","source":"Crossref","is-referenced-by-count":66,"title":["Safety of direct oral anticoagulants vs warfarin in patients with chronic liver disease and atrial fibrillation"],"prefix":"10.1111","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6875-3082","authenticated-orcid":false,"given":"Pavel","family":"Goriacko","sequence":"first","affiliation":[{"name":"Montefiore Medical Center Wakefield Division  Bronx NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith T.","family":"Veltri","sequence":"additional","affiliation":[{"name":"Touro College of Pharmacy  New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,3,13]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2010.08.014"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0029-1145259"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1011170"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.4103\/0975-3583.95363"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.25623"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000041"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.116.005307"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0905561"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1107039"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1310907"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1009638"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/ejh.12844"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-015-4012-2"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.13285"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.20906"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2010.03064.x"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2005.01204.x"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(95)00048-8"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11938-016-0092-0"},{"key":"e_1_2_7_22_1","unstructured":"PRADAXA\u00ae (dabigatran etexilate mesylate) capsules for oral use [Prescribing Information]. 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