Physicians' Academy for Cardiovascular Education

DOACs associated with lower risk of liver injury hospitalisation compared to warfarin

Prospective study of oral anticoagulants and risk of liver injury in patients with atrial fibrillation

Literature - Alonso A, MacLehose RF, Chen LY et al. - Heart. 2017 Jan 5, doi:10.1136/heartjnl-2016-310586

Main results


Although literature describes isolated case reports of hepatotoxicity linked to DOACs, the risk of liver injury hospitalisation among patients starting DOACs was lower than those starting warfarin. Among DOACs, risk was highest for rivaroxaban users compared with dabigatran and apixaban users. Moreover, several patient characteristics were predictive for liver injury hospitalisation which were used in an excel-based calculator that can help clinicians deciding between anticoagulants.


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