FREQUENCY OF MAJOR BLEEDING EPISODES WITH RIVAROXABAN FOR ATRIAL FIBRILLATION RELATED STROKE PREVENTION IN CHRONIC KIDNEY DISEASE PATIENTS

Abstract

Objectives: To determine frequency of bleeding complications with Rivaroxaban for Atrial Fibrillation in patients of chronic kidney disease (CKD).

Methodology: This Descriptive study was conducted on 280 patients fulfilling the inclusion criteria. After approval from Ethical Review Committee of Jinnah Hospital Lahore and informed consent, participants received tab. Rivaroxaban 20mg daily (Creatinine-Clearance >50mL/Min). Participants were followed for 4-weeks for any major bleeding complications. All information was collected on a questionnaire and results were calculated.

Results: In our study, Mean age of participants was 55±11 years with 59% males and 41% females. Mean duration of CKD calculated was 6±4 years. In this study major bleeding episodes occurred in 36 participants out of 280; 15 participants in age group up to 50 years and 21 participants in above 50 years developed it. It occurred in 20 males and 16 females; 5 cases in group with CHADS₂VaSc score (annexure 2) up to 5 and 31 cases in those with score more than 5, no case occurred with less than 1 year duration of CKD while 4 cases with CKD in between 1 to 3 years and 32 cases with CKD more than 3 years developed major bleeding.

Conclusion: Major bleeding episodes occurred in a significant number of CKD patients with use of Rivaroxaban. This bleeding incidence had no association with age, sex and duration of CKD. Increased rates were associated with increased CHADS₂VASc score especially for fall in Hb and microscopic hematuria.