Operative survival in patients with acute aortic disease in the era of newer oral anticoagulants release_cuxyi6z5hjejvfgsc5i7jtfopq

by Johannes Lagethon Bjørnstad, Adil Mahboob Khan, Henriette Røed-Undlien, Bjørn Bendz, Ståle Nygård, Tom Nilsen Hoel, Per Snorre Lingaas

Published in Open Heart by BMJ.

2020   Volume 7, Issue 2, e001278

Abstract

<jats:sec><jats:title>Aims</jats:title>The aim of this study was the analysis of the risk associated with direct oral anticoagulants (DOACs) in patients undergoing non-elective operations on the proximal aorta due to aortic disease.</jats:sec><jats:sec><jats:title>Methods and results</jats:title>Data from the department's register of cardiac surgery was analysed retrospectively with emphasis on operative mortality. 135 non-elective operations for proximal aortic disease (October 2016 to 2018) were identified, of which 19 died during the first 90 days. DOAC use was the top-ranked risk factor in the univariate analysis with a HR of 9.6 (3.1 to 29), p=0.00007. Using a Cox proportional hazards model including the most relevant risk factors, the risk associated with DOAC use remained significant with a HR of 6.1 (1.4 to 26.3), p=0.015. We did not find increased risk associated with warfarin use.</jats:sec><jats:sec><jats:title>Conclusion</jats:title>In patients undergoing non-elective operations on the proximal aorta due to aortic disease, the use of DOAC is associated with increased operative mortality.</jats:sec>
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