16 / 23
allied
academies
Journal of Pharmacology and Therapeutic Research
Volume 1 Issue 1
Clinical Pharmacy 2017
Notes:
Page 33
December 07-09, 2017 | Rome, Italy
7
th
World Congress on
Clinical Pharmacy and Pharmacy Practice
Comparison of direct-acting oral
anticoagulants in non-obese and obese
patients with atrial fibrillation
Huyentran Tran, Dimpa Choksi, Rebecca Tran
and
Elvin Hernandez
Loma Linda University, USA
Introduction:
Currently, there are four direct-acting oral
anticoagulants (DOACs) approved in the United States.
While dabigatran is a direct thrombin inhibitor, rivaroxaban,
apixaban, and edoxaban are factor Xa inhibitors. Though
DOACs exhibit predominately renal elimination, there is
limited evidence regarding safety and efficacy of these
agents in the obese population.
The purpose of Study:
The purpose of this research is to
add to current literature regarding the safety and efficacy
of DOACs in obese patients with atrial fibrillation (AF), as
to date, there is no study that has specifically studied this
population.
Study Design:
This retrospective, observational study
included adults prescribed a DOAC between January
1, 2010 and September 30, 2016 in a multi-disciplinary
outpatient AF clinic at a large academic medical center.
Methods:
The primary objective is to compare incidence
of thromboembolic or bleeding events in patients with AF
with body mass index (BMI) <30 kg/m2 to patients with
BMI≥30 kg/m2. Secondary objectives are to compare the
incidence of events with each DOAC separately. Pearson
Chi-Square and Fisher’s Exact Test were used when
appropriate.
Results:
Preliminary data consists of 344 patients. The
primary composite endpoint of thromboembolic and
bleedings occurred in 44 (27%) of patients with BMI
<30 kg/m2 versus 32 (18%) patients with BMI ≥30 kg/m
2
(p=0.038). In a subgroup analysis of dabigatran, stroke or
bleed rate was 22% (n=4) in non-obese patients versus
11% (n=2) in obese patients (p=0.37). In the rivaroxaban
group, stroke or bleed rate was 29% (n=18) in non-obese
patients versus 20% (n=19) in obese patients (p=0.22).
In the apixaban group, stroke or bleed rate was 27%
(n=22) in non-obese patients versus 16% (n=11) in obese
patients (p=0.11). In the edoxaban group, there was one
event in each arm.
Conclusion:
Preliminary data suggests patients with BMI
≥30 kg/m2 do not have higher incidence of thromboembolic
or bleeding events when compared to patients with BMI
<30 kg/m
2
.
Biography
Huyentran Tran has received her Doctor of Pharmacy degree from Loma Linda
University School of Pharmacy (LLUSP) in 2010. She has completed a PGY1
Pharmacy Practice Residency at Desert Regional Medical Center in Palm
Springs and a PGY2 Cardiology Specialty Residency at LLUSP. She has joined
the LLUSP faculty in 2012. Currently, she participates in a multidisciplinary
collaborative team at LLU International Heart Institute and LLU Medical Center
to provide comprehensive care for patients with cardiovascular disorders and
serves as a preceptor for students and residents. She is the Coordinator of LLU
PGY2 Cardiology Pharmacy Residency Program.
huytran@llu.eduHuyentran Tran et al., J Pharmacol Ther Res 2017