タカダ　タクマ   TAKADA Takuma   髙田　卓磨    所属   研究施設 研究施設    職種   助教
言語種別	英語
発表タイトル	Risk Factor for Major Bleeding during Direct Oral Anticoagulant Therapy in Patients with Venous Thromboembolism: From the COMMAND VTE Registry-2
会議名	第87回日本循環器学会学術集会
学会区分	全国規模の学会
発表形式	口頭
講演区分	一般
発表者・共同発表者	Yuki Ueno, Satoshi Ikeda, Koji Maemura, Ryuki Chatani, Kazuhisa Kaneda, Yuji Nishimoto, Nobutaka Ikeda, Yohei Kobayashi, Kite Kim, Toru Takase, Shuhei Tsuji, Maki Ohi, Takuma Takada, Kazunori Otsui, Jiro Sakamoto, Yoshito Ogihara, Yugo Yamashita
発表年月日	2023/03/10
開催地 （都市, 国名）	福岡
概要	Background: Bleeding events have been a critical issue in patients receiving the anticoagulant therapy. However, the incidence and risk factors for major bleeding during the treatment of venous thromboembolism (VTE) with direct oral anticoagulants (DOACs), currently widely used anticoagulants, have not been fully evaluated especially in Japan. Methods: The COMMAND VTE Registry-2 is a multicenter registry enrolling 5,197 consecutive acute symptomatic VTE patients among 31 centers in Japan between January 2015 and August 2020. The current study population consisted of 4,128 patients with and without major bleeding during DOACs administration (2,004 edoxaban, 1,206 rivaroxaban, 912 apixaban, and 6 dabigatoran). We investigated the associations between major bleeding and patients' demographics and identified its risk factors. Results: Major bleeding events occurred in 275 patients (6.7%) during the median follow-up period of 274 days. The patients with major bleeding had a higher proportion of previous major bleeding and stroke, a more comorbidity of active cancer, and lower levels of hemoglobin, body weight and creatinine clearance, compared with those without. The cumulative incidence of major bleeding was 1.4% at 3-month, 2.3% at 1-year, and 3.6% at 3-year. The multivariable Cox regression model identified that active cancer (Hazard ratio [HR] 2.07, 95% confidence interval [CI] 1.60-2.68), previous major bleeding (HR 2.97, 95% CI 2.06-4.28), and anemia (HR 1.91, 95% CI 1.44-2.52) were independently associated with an increased risk for major bleeding. Conclusions: DOAC-related major bleeding occurred in less than 3% at 1-year. Active cancer, previous major bleeding, and anemia were the independent risk factors for major bleeding in VTE patients receiving DOACs.