Long-term anticoagulant therapy in patients with diabetes mellitus and atrial fibrillation – possibilities and hazards


Authors: Matej Samoš 1;  Tomáš Bolek 1;  Dana Prídavková 1;  Rid Škorňová 2;  Kristína Grilusová 1;  Ján Staško 2;  Marián Mokáň 1
Authors‘ workplace: I. interná klinika JLF UK a UNM, Martin 1;  Národné centrum trombózy a hemostázy SR, Klinika hematológie a transfuziológie JLF UK a UNM, Martin 2
Published in: Forum Diab 2021; 10(2): 80-86
Category:

Overview

Atrial fibrillation (AF) is the most frequent supraventricular heart rhythm disorder in patients with diabetes mellitus (DM). DM is connected with higher risk of stroke and systemic embolism in patients with AF. Recently, it is not entirely clear how efficient and safe is long-term anticoagulation in patients with DM and whether DM affects the clinical efficacy of long-term oral anticoagulation in patients with AF. This article reviews data on efficacy and safety of recently available oral anticoagulant therapy in patients with DM and discusses on some of the hazards and unexplained questions which are connected with this therapy.

Keywords:

atrial fibrillation – diabetes mellitus – direct oral anticoagulants


Sources

1. Nichols GA, Reinier K, Chugh SS. Independent contribution of diabetes to increased prevalence and incidence of atrial fibrillation. Diabetes Care 2009; 32(10): 1851–1856. Dostupné z DOI: <http://doi:10.2337/dc09–0939>.

2. Tadic M, Cuspidi C. Type 2 diabetes mellitus and atrial fibrillation: From mechanisms to clinical practice. Arch Cardiovasc Dis 2015; 108(4): 269–276. Dostupné z DOI: <http://doi: 10.1016/j.acvd.2015.01.009>.

3. Klem I, Wehinger C, Schneider B et al. Diabetic atrial fibrillation patients: mortality and risk for stroke or embolism during a 10-year follow- up. Diabetes Metab Res Rev 2003; 19(4): 320–328. Dostupné z DOI: <http://doi: 10.1002/dmrr.386>.

4. Hankey GJ, Jamrozik K, Broadhurst RJ et al. Long-term disability after first-ever stroke and related prognostic factors in the Perth Community Stroke Study, 1989–1990. Stroke 2002; 33(4): 1034–1040. Dostupné z DOI: <http://doi: 10.1161/01.str.0000012515.66889.24>.

5. Hindricks G, Potpara T, Dagres N et al. [ESC Scientific Document Group]. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 2021; 42(5): 373–498. Dostupné z DOI: <http://doi: 10.1093/eurheartj/ehaa612>.

6. Prídavková D, Samoš M, Bolek T et al. Type 2 Diabetes, Atrial Fibrillation, and Direct Oral Anticoagulation. J Diabetes Res 2019; 2019: 5158308. Dostupné z DOI: <http://doi: 10.1155/2019/5158308>.

7. Liang HF, Du X, Zhou YC et al. Control of Anticoagulation Therapy in Patients with Atrial Fibrillation Treated with Warfarin: A Study from the Chinese Atrial Fibrillation Registry. Med Sci Monit 2019; 25: 4691– 4698. Dostupné z DOI: <http://doi: 10.12659/MSM.917131>.

8. Lee A, Crowther M. Practical issues with vitamin K antagonists: elevated INRs, low time-in-therapeutic range, and warfarin failure. J Thromb Thrombolysis 2011; 31(3): 249–258. Dostupné z DOI: <http://doi: 10.1007/s11239–011–0555-z>.

9. Blüher M, Kurz I, Dannenmaier S et al. Pill Burden in Patients With Type 2 Diabetes in Germany: Subanalysis From the Prospective, Noninterventional PROVIL Study. Clin Diabetes 2015; 33(2): 55–61. Dostupné z DOI: <http://doi: 10.2337/diaclin.33.2.55>.

10. Antonijevic NM, Zivkovic ID, Jovanovic LM et al. Dabigatran-Metabolism, Pharmacologic Properties and Drug Interactions. Curr Drug Metab 2017; 18(7): 622–635. Dostupné z DOI: <http://doi: 10.2174/1389200218666170427113504>.

11. Brambatti M, Darius H, Oldgren J et al. Comparison of dabigatran versus warfarin in diabetic patients with atrial fibrillation: Results from the RE-LY trial. Int J Cardiol 2015; 196: 127–131. Dostupné z DOI: <http://doi: 10.1016/j.ijcard.2015.05.141>.

12. Hsu CC, Hsu PF, Sung SH et al. Is There a Preferred Stroke Prevention Strategy for Diabetic Patients with Non-Valvular Atrial Fibrillation? Comparing Warfarin, Dabigatran and Rivaroxaban. Thromb Haemost 2018; 118(1): 72–81. Dostupné z DOI: <http://doi: 10.1160/TH17–02–0095>.

13. Samoš M, Bolek T, Stančiaková L et al. Does type 2 diabetes affect the on-treatment levels of direct oral anticoagulants in patients with atrial fibrillation? Diabetes Res Clin Pract 2018; 135: 172–177. Dostupné z DOI: <http://doi: 10.1016/j.diabres.2017.11.024>.

14. Kubisz P, Stanciakova L, Dobrotova M et al. Apixaban-Metabolism, Pharmacologic Properties and Drug Interactions. Curr Drug Metab 2017; 18(7): 609–621. Dostupné z DOI: <http://doi: 10.2174/1389200218666170424151551>.

15. Ezekowitz JA, Lewis BS, Lopes RD et al. Clinical outcomes of patients with diabetes and atrial fibrillation treated with apixaban: results from the ARISTOTLE trial. Eur Heart J Cardiovasc Pharmacother 2015; 1(2): 86–94. Dostupné z DOI: <http://doi: 10.1093/ehjcvp/pvu024>.

16. Siontis KC, Zhang X, Eckard A et al. Outcomes Associated With Apixaban Use in Patients With End-Stage Kidney Disease and Atrial Fibrillation in the United States. Circulation 2018; 138(15): 1519–1529. Dostupné z DOI: <http://doi: 10.1161/CIRCULATIONAHA.118.035418>.

17. Lopes RD, Heizer G, Aronson R et al. [AUGUSTUS Investigators]. Antithrombotic Therapy after Acute Coronary Syndrome or PCI in Atrial Fibrillation. N Engl J Med 2019; 380(16): 1509–1524. Dostupné z DOI: <http://doi: 10.1056/NEJMoa1817083>.

18. Kvasnicka T, Malikova I, Zenahlikova Z et al. Rivaroxaban – Metabolism, Pharmacologic Properties and Drug Interactions. Curr Drug Metab 2017; 18(7): 636–642. Dostupné z DOI: <http://doi: 10.2174/1389200218666170518165443>.

19. Bansilal S, Bloomgarden Z, Halperin JL et al. [ROCKET AF Steering Committee and Investigators]. Efficacy and safety of rivaroxaban in patients with diabetes and nonvalvular atrial fibrillation: the Rivaroxaban Once-daily, Oral, Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF Trial). Am Heart J 2015; 170(4): 675–682. e8. Dostupné z DOI: <http://doi: 10.1016/j.ahj.2015.07.006>.

20. Gibson CM, Mehran R, Bode C et al. Prevention of Bleeding in Patients with Atrial Fibrillation Undergoing PCI. N Engl J Med 2016; 375(25): 2423–2434. Dostupné z DOI: <http://doi: 10.1056/NEJMoa1611594>.

21. Coleman CI, Costa OS, Brescia CW et al. Thromboembolism, bleeding and vascular death in nonvalvular atrial fibrillation patients with type 2 diabetes receiving rivaroxaban or warfarin. Cardiovasc Diabetol 2021; 20(1): 52. Dostupné z DOI: <http://doi: 10.1186/s12933–021–01250–5>.

22. Peacock WF, Tamayo S, Sicignano N et al. Comparison of the Incidence of Major Bleeding With Rivaroxaban Use Among Nonvalvular Atrial Fibrillation Patients With Versus Without Diabetes Mellitus. Am J Cardiol 2017; 119(5): 753–759. Dostupné z DOI: <http://doi: 10.1016/j.amjcard.2016.11.023>.

23. Hua Y, Sun JY, Su Y et al. The Safety and Efficacy of Rivaroxaban Compared with Warfarin in Patients with Atrial Fibrillation and Diabetes: A Systematic Review and Meta-analysis. Am J Cardiovasc Drugs 2021; 21(1): 51–61. Dostupné z DOI: <http://doi: 10.1007/s40256–020–00407-z>.

24. Lip GY, Agnelli G. Edoxaban: a focused review of its clinical pharmacology. Eur Heart J 2014; 35(28): 1844–1855. Dostupné z DOI: <http://doi: 10.1093/eurheartj/ehu181>.

25. Plitt A, Ruff CT, Goudev A et al. Efficacy and safety of edoxaban in patients with diabetes mellitus in the ENGAGE AF-TIMI 48 trial. Int J Cardiol 2020; 304: 185–191. Dostupné z DOI: <http://doi: 10.1016/j.ijcard.2020.01.009>.

26. Russo V, Attena E, Rago A et al. Clinical Outcome of Edoxaban vs. Vitamin K Antagonists in Patients with Atrial Fibrillation and Diabetes Mellitus: Results from a Multicenter, Propensity-Matched, Real-World Cohort Study. J Clin Med 2020; 9(6): 1621. Dostupné z DOI: <http://doi:10.3390/jcm9061621>.

27. Zou R, Tao J, Shi W et al. Meta-analysis of safety and efficacy for direct oral anticoagulation treatment of non-valvular atrial fibrillation in relation to renal function. Thromb Res 2017; 160: 41–50. Dostupné z DOI: <http://doi: 10.1016/j.thromres.2017.10.013>.

28. Pfrepper C, Peschka A, Weidhase L et al. Management of Dabigatran- associated bleeding in two elderly patients with acute renal failure. Ann Hematol 2018; 97(12): 2519–2521. Dostupné z DOI: <http://doi: 10.1007/s00277–018–3376–8>.

29. Pathak R, Pandit A, Karmacharya P, Aryal MR, Ghimire S, Poudel DR, Shamoun FE. Meta-analysis on risk of bleeding with apixaban in patients with renal impairment. Am J Cardiol 2015; 115(3): 323–327. Dostupné z DOI: <http://doi: 10.1016/j.amjcard.2014.10.042>.

30. Fazio G, Dentamaro I, Gambacurta R et al. Safety of Edoxaban 30 mg in Elderly Patients with Severe Renal Impairment. Clin Drug Investig 2018; 38(11): 1023–1030. Dostupné z DOI: <http://doi: 10.1007/s40261–018–0693–6>.

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Diabetology Endocrinology Internal medicine

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