Impact of amiodarone on plasma concentration of direct oral anticoagulant in patients with atrial fibrillation

• DOI: 10.1016/j.jfma.2023.02.012
• Publication Date: 2023-03-06T14:38:59Z
• Authors: Shin-Yi Lin; Yen-Bin Liu; Li-Ting Ho; Yu-Fong Peng; Ching-Hua Kuo; Sung-Chun Tang; Chih-Fen Huang; Jiann-Shing Jeng
• Keywords: Gastrointestinal bleeding

Amiodarone increases exposure of direct oral anticoagulants (DOACs). We aimed to analyze the effects concurrent amiodarone use on DOAC concentrations and clinical outcomes. Patients who were ≥20 years age, had atrial fibrillation, took enrolled provide trough peak samples for concentration measurements using ultra-high-performance liquid chromatography-tandem mass spectrometry. The results compared with reported in trials define above, within, or under expected range. outcomes interest major bleeding any gastrointestinal bleeding. Multivariate logistic regression Cox proportional hazards model used determine impact above-range outcomes, respectively. A total 722 participants (420 men, 58.2%) 691 689 samples. Among them, 21.3% concurrently amiodarone. proportion patients was 16.4% 30.2%, respectively, users, contrast 9.4% 19.8% non-users. associated (odds ratio [OR] = 2.00 [1.16, 3.47] 1.82 [1.19, 2.79], respectively). However, not a significant predictor Concurrent led increased but higher risk Therapeutic monitoring users taking may be recommended an additional exposure.