Dabigatran and the Risk of Staphylococcus aureus Bacteremia: A Nationwide Cohort Study
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Dabigatran and the Risk of Staphylococcus aureus Bacteremia : A Nationwide Cohort Study. / Butt, Jawad H.; Fosbøl, Emil L.; Verhamme, Peter; Gerds, Thomas A.; Iversen, Kasper; Bundgaard, Henning; Bruun, Niels Eske; Larsen, Anders R.; Petersen, Andreas; Andersen, Paal S.; Skov, Robert L.; Gislason, Gunnar H.; Torp-Pedersen, Christian; Køber, Lars; Olesen, Jonas B.
In: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, Vol. 73, No. 3, 2021, p. 480-486.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Dabigatran and the Risk of Staphylococcus aureus Bacteremia
T2 - A Nationwide Cohort Study
AU - Butt, Jawad H.
AU - Fosbøl, Emil L.
AU - Verhamme, Peter
AU - Gerds, Thomas A.
AU - Iversen, Kasper
AU - Bundgaard, Henning
AU - Bruun, Niels Eske
AU - Larsen, Anders R.
AU - Petersen, Andreas
AU - Andersen, Paal S.
AU - Skov, Robert L.
AU - Gislason, Gunnar H.
AU - Torp-Pedersen, Christian
AU - Køber, Lars
AU - Olesen, Jonas B.
N1 - Publisher Copyright: © The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.
PY - 2021
Y1 - 2021
N2 - BACKGROUND: Treatment with dabigatran, an oral direct thrombin inhibitor, reduces the virulence of Staphylococcus aureus in in vitro and in vivo models. However, it remains to be determined whether dabigatran reduces the risk of S. aureus infections in humans. We investigated the incidence rate of S. aureus bacteremia (SAB) in patients with atrial fibrillation treated with the direct thrombin inhibitor dabigatran compared with patients treated with the factor Xa-inhibitors rivaroxaban, apixaban, and edoxaban. METHODS: In this observational cohort study, 112 537 patients with atrial fibrillation who initiated treatment with direct oral anticoagulants (August 2011-December 2017) were identified from Danish nationwide registries. The incidence rates of SAB in patients treated with dabigatran versus patients treated with the factor Xa-inhibitors were examined by multivariable Cox regression accounting for time-dynamic changes in exposure status during follow-up. RESULTS: A total of 112 537 patients were included. During a median follow-up of 2.0 years, 186 patients in the dabigatran group and 356 patients in the factor Xa-inhibitor group were admitted with SAB. The crude incidence rate of SAB was lower in the dabigatran group compared with the factor Xa-inhibitor group (22.8 [95% confidence interval [CI], 19.7-26.3] and 33.8 [95% CI, 30.5-37.6] events per 10 000 person-years, respectively). In adjusted analyses, dabigatran was associated with a significantly lower incidence rate of SAB compared with factor Xa-inhibitors (incidence rate ratio, .76; 95% CI, .63-.93). CONCLUSIONS: Treatment with dabigatran was associated with a significantly lower incidence rate of SAB compared with treatment with factor Xa-inhibitors.
AB - BACKGROUND: Treatment with dabigatran, an oral direct thrombin inhibitor, reduces the virulence of Staphylococcus aureus in in vitro and in vivo models. However, it remains to be determined whether dabigatran reduces the risk of S. aureus infections in humans. We investigated the incidence rate of S. aureus bacteremia (SAB) in patients with atrial fibrillation treated with the direct thrombin inhibitor dabigatran compared with patients treated with the factor Xa-inhibitors rivaroxaban, apixaban, and edoxaban. METHODS: In this observational cohort study, 112 537 patients with atrial fibrillation who initiated treatment with direct oral anticoagulants (August 2011-December 2017) were identified from Danish nationwide registries. The incidence rates of SAB in patients treated with dabigatran versus patients treated with the factor Xa-inhibitors were examined by multivariable Cox regression accounting for time-dynamic changes in exposure status during follow-up. RESULTS: A total of 112 537 patients were included. During a median follow-up of 2.0 years, 186 patients in the dabigatran group and 356 patients in the factor Xa-inhibitor group were admitted with SAB. The crude incidence rate of SAB was lower in the dabigatran group compared with the factor Xa-inhibitor group (22.8 [95% confidence interval [CI], 19.7-26.3] and 33.8 [95% CI, 30.5-37.6] events per 10 000 person-years, respectively). In adjusted analyses, dabigatran was associated with a significantly lower incidence rate of SAB compared with factor Xa-inhibitors (incidence rate ratio, .76; 95% CI, .63-.93). CONCLUSIONS: Treatment with dabigatran was associated with a significantly lower incidence rate of SAB compared with treatment with factor Xa-inhibitors.
KW - S. aureus
KW - dabigatran
KW - epidemiology
U2 - 10.1093/cid/ciaa661
DO - 10.1093/cid/ciaa661
M3 - Journal article
C2 - 32478836
AN - SCOPUS:85100843361
VL - 73
SP - 480
EP - 486
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
SN - 1058-4838
IS - 3
ER -
ID: 279195057