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Am J Surg ; 210(6): 1095-102; discussion 1102-3, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26482512

RESUMO

BACKGROUND: The novel oral anticoagulants (NOACs) apixaban, rivaroxaban, and dabigatran are indicated for the treatment of nonvalvular atrial fibrillation, but their use in patients with postoperative atrial fibrillation (POAF) is less well defined. METHODS: All patients undergoing isolated coronary artery bypass grafting from 2013 to 2015 (n = 598) were studied. Patients with POAF anticoagulated with either warfarin or NOACs were evaluated for differences in length of stay, blood product use, bleeding, and cost of therapy. RESULTS: There was no significant difference between the NOAC and warfarin group for any of the clinical outcomes evaluated. Time to therapeutic anticoagulation was significantly longer with warfarin. Neither group had a major bleeding event during the initial hospitalization, but 2 patients in the warfarin group had delayed major bleeding complications. Total costs were significantly reduced in patients treated with NOACs. CONCLUSIONS: Both NOACs and warfarin are safe and effective means of anticoagulation for POAF after coronary artery bypass grafting. Patients were therapeutic more rapidly and with less cost of treatment when NOACs were used.


Assuntos
Anticoagulantes/uso terapêutico , Fibrilação Atrial/tratamento farmacológico , Ponte de Artéria Coronária , Varfarina/uso terapêutico , Administração Oral , Idoso , Anticoagulantes/economia , Fibrilação Atrial/etiologia , Transfusão de Componentes Sanguíneos/estatística & dados numéricos , Dabigatrana/economia , Dabigatrana/uso terapêutico , Custos de Medicamentos , Feminino , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Pirazóis/economia , Pirazóis/uso terapêutico , Piridonas/economia , Piridonas/uso terapêutico , Rivaroxabana/economia , Rivaroxabana/uso terapêutico , Resultado do Tratamento , Varfarina/economia
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