{"id":1759,"date":"2022-11-04T00:00:00","date_gmt":"2022-11-04T04:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/association-between-concurrent-use-of-amiodarone-and-doacs-and-risk-of-bleeding-in-patients-with-atrial-fibrillation\/"},"modified":"2023-06-14T19:48:30","modified_gmt":"2023-06-14T23:48:30","slug":"association-between-concurrent-use-of-amiodarone-and-doacs-and-risk-of-bleeding-in-patients-with-atrial-fibrillation","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/association-between-concurrent-use-of-amiodarone-and-doacs-and-risk-of-bleeding-in-patients-with-atrial-fibrillation\/","title":{"rendered":"Association between concurrent use of amiodarone and DOACs and risk of bleeding in patients with atrial fibrillation"},"content":{"rendered":"<p>Amiodarone is a commonly used pharmacotherapy in patients with atrial fibrillation (AF), with a potential for drug-drug interactions with direct oral anticoagulants (DOACs). We aimed to assess the bleeding risk after co-prescription of amiodarone and DOACs among adults with AF. We conducted a population-based, nested case-control study in Ontario, Canada. The study population included all patients with AF aged &gt;66 years on a DOAC between April 1, 2011 and March 31, 2018. Cases were patients admitted with major bleeding (index date). Controls were matched in a 2:1 ratio to cases. We categorized exposure to amiodarone before the index date as: (1) current users (amiodarone within 60 days), (2) past users (amiodarone within 61 to 140 days), and (3) unexposed (no amiodarone prescription or amiodarone prescription &gt;140 days before index date). Conditional logistic regression models were used to examine the association between bleeding and amiodarone co-prescription. Among 86,679 patients with AF on a DOAC, we identified 2,766 cases (3.2%) admitted with major bleeding. The median age of patients with AF was 80 years (interquartile range 75 to 85); 48.3% were women. After multivariable adjustment, there was a significant association between major bleeding and current use of amiodarone (adjusted odds ratio 1.53; 95% confidence interval 1.24 to 1.89, p &lt;0.001) but no significant association between major bleeding and past use of amiodarone (adjusted odds ratio 1.13, 95% confidence interval 0.76 to 1.68, p = 0.545) compared with the unexposed group. In conclusion, among older patients with AF on a DOAC, there was 53% increased odds of major bleeding with the current use of amiodarone.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Amiodarone is a commonly used pharmacotherapy in patients with atrial fibrillation (AF), with a potential for drug-drug interactions with direct oral anticoagulants (DOACs). We aimed to assess the bleeding risk after co-prescription of amiodarone and DOACs among adults with AF. We conducted a population-based, nested case-control study in Ontario, Canada. The study population included all [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[],"migration-helper-qa-sample-set":[],"class_list":["post-1759","journal_article","type-journal_article","status-publish","hentry"],"acf":{"citation":"Shurrab M, Jackevicius CA, Austin PC, Tu K, Qiu F, Singh SM, Crystal E, Caswell J, Michael F, Andrade JG, Ko DT. <em>Am J Cardiol<\/em>. 2022; Nov 4 [Epub ahead of print].","source_url":"https:\/\/doi.org\/10.1016\/j.amjcard.2022.10.031","ices_scientist":[1281,1385,1146,20901],"site":[6733],"research_program":[6742],"news_release":[],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"2429FF3F-F228-4428-9CF1-8AEA4CE511C7","sitecore_item_name":"Association-between-concurrent-use-of-amiodarone-and-DOACs-and-risk-of-bleeding","sitecore_field_values":"{\n  \"Title\": \"Association between concurrent use of amiodarone and DOACs and risk of bleeding in patients with atrial fibrillation\",\n  \"Short title\": \"Association between concurrent use of\",\n  \"Summary\": \"This study aimed to assess the bleeding risk after co-prescription of amiodarone and direct oral anticoagulants among adults with atrial fibrillation.\",\n  \"Citation\": \"<p>Shurrab M, Jackevicius CA, Austin PC, Tu K, Qiu F, Singh SM, Crystal E, Caswell J, Michael F, Andrade JG, Ko DT. <em>Am J Cardiol<\/em>. 2022; Nov 4 [Epub ahead of print]. DOI: <a href=\"https:\/\/doi.org\/10.1016\/j.amjcard.2022.10.031\" title=\"opens external link\">https:\/\/doi.org\/10.1016\/j.amjcard.2022.10.031<\/a><\/p>\",\n  \"Abstract\": \"<p>Amiodarone is a commonly used pharmacotherapy in patients with atrial fibrillation (AF), with a potential for drug-drug interactions with direct oral anticoagulants (DOACs). We aimed to assess the bleeding risk after co-prescription of amiodarone and DOACs among adults with AF. We conducted a population-based, nested case-control study in Ontario, Canada. The study population included all patients with AF aged &gt;66 years on a DOAC between April 1, 2011 and March 31, 2018. Cases were patients admitted with major bleeding (index date). Controls were matched in a 2:1 ratio to cases. We categorized exposure to amiodarone before the index date as: (1) current users (amiodarone within 60 days), (2) past users (amiodarone within 61 to 140 days), and (3) unexposed (no amiodarone prescription or amiodarone prescription &gt;140 days before index date). Conditional logistic regression models were used to examine the association between bleeding and amiodarone co-prescription. Among 86,679 patients with AF on a DOAC, we identified 2,766 cases (3.2%) admitted with major bleeding. The median age of patients with AF was 80 years (interquartile range 75 to 85); 48.3% were women. After multivariable adjustment, there was a significant association between major bleeding and current use of amiodarone (adjusted odds ratio 1.53; 95% confidence interval 1.24 to 1.89, p &lt;0.001) but no significant association between major bleeding and past use of amiodarone (adjusted odds ratio 1.13, 95% confidence interval 0.76 to 1.68, p = 0.545) compared with the unexposed group. In conclusion, among older patients with AF on a DOAC, there was 53% increased odds of major bleeding with the current use of amiodarone.<\/p>\",\n  \"Research Programs\": \"{BEC72DE0-BA8C-42B8-ACE5-EE29FFB2CB3B}\",\n  \"ICES Locations\": \"{4FCAABBA-14A5-42E6-8F33-BC6C2F1D9908}\",\n  \"ICES Scientists\": \"{BA86E62A-3468-443D-939F-34A9EFA7B7AA}|{7D498E8B-5801-4F9E-AC41-11ED50F3C34E}|{B3827152-93D1-4FB2-B106-590CB331A264}\",\n  \"Posted Date\": \"20221104T000000\",\n  \"Show on Publications Landing Page\": \"1\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2022\/November\/Association-between-concurrent-use-of-amiodarone-and-DOACs-and-risk-of-bleeding"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Association between concurrent use of amiodarone and DOACs and risk of bleeding in patients with atrial fibrillation<\/title>\n<meta name=\"description\" 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