Heavy menstrual bleeding in women on oral anticoagulants

被引:25
作者
Bannow, Bethany T. Samuelson [1 ,2 ]
Chi, Vivia [3 ]
Sochacki, Paul [4 ]
McCarty, Owen J. T. [5 ]
Baldwin, Maureen K. [6 ]
Edelman, Alison B. [6 ]
机构
[1] Oregon Hlth & Sci Univ, Hemophilia Ctr OHSU, 3181 SW Sam Jackson Pk Rd, Portland, OR 97239 USA
[2] Oregon Hlth & Sci Univ, Knight Canc Inst, 3181 SW Sam Jackson Pk Rd, Portland, OR 97239 USA
[3] Oregon Hlth & Sci Univ, OHSU Sch Med, 3181 SW Sam Jackson Pk Rd, Portland, OR 97239 USA
[4] Bio Lab Analyt LLC, Vancouver, WA USA
[5] Oregon Hlth & Sci Univ, Dept Biomed Engn, 3181 SW Sam Jackson Pk Rd, Portland, OR 97239 USA
[6] Oregon Hlth & Sci Univ, Dept Obstet & Gynecol, 3181 SW Sam Jackson Pk Rd, Portland, OR 97239 USA
基金
美国国家卫生研究院;
关键词
Heavy menstrual bleeding; Anticoagulation; Rivaroxaban; Apixaban; Warfarin; VENOUS THROMBOEMBOLISM;
D O I
10.1016/j.thromres.2020.11.014
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Although heavy menstrual bleeding (HMB) is a known complication of anticoagulant therapy, rates of HMB in users of the direct oral anticoagulants (OACs) apixaban and rivaroxaban are largely unknown. Methods: We performed a retrospective cohort study of menstruating women prescribed rivaroxaban, apixaban and warfarin over a six-year period (2012-2018). The primary outcome was HMB requiring medical or surgical intervention. We used descriptive statistics and logistic regression to evaluate associations between OAC type, age, history of HMB, and the primary outcome. Results: We identified 195 women of reproductive-age with a new therapeutic OAC prescription (62 on rivaroxaban, 54 on apixaban, 79 on warfarin). A minority (26/195, 13.3%) had a documented history of HMB, including 9 rivaroxaban users, 7 apixaban users and 10 warfarin users but most women (117/195, 60%) had no menstrual history documented. One third of subjects (64/195) required treatment for HMB within 6 months of starting OAC therapy. After controlling for a history of HMB, rivaroxaban users were 1.4 times more likely to require treatment as compared to users of other OACs. Discussion: We found an association between rates of HMB necessitating medical or surgical intervention and rivaroxaban use. We also found that the majority of women did not have a documented menstrual history, suggesting that many providers do not inquire about menstrual bleeding when starting OAC therapy. Menstruating women, particularly those with a history of HMB, may be at increased risk for HMB necessitating medical treatment depending on the type of OAC used.
引用
收藏
页码:114 / 119
页数:6
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