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Volume 15 Issue 1
Jan.  2024
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ZHANG Wenjing, ZHU Tienan, LI Kuixing. Oral Anticoagulation Therapy Increased the Incidence of Abnormal Uterine Bleeding in Patients with Thrombophilia: A Single-center Retrospective Study[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(1): 117-123. DOI: 10.12290/xhyxzz.2023-0265
Citation: ZHANG Wenjing, ZHU Tienan, LI Kuixing. Oral Anticoagulation Therapy Increased the Incidence of Abnormal Uterine Bleeding in Patients with Thrombophilia: A Single-center Retrospective Study[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(1): 117-123. DOI: 10.12290/xhyxzz.2023-0265
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Oral Anticoagulation Therapy Increased the Incidence of Abnormal Uterine Bleeding in Patients with Thrombophilia: A Single-center Retrospective Study

  • 1.

    Graduate College, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

  • 2.

    Nursing Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

  • 3.

    Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

Funds: 

National High Level Hospital Clinical Research Funding 2022-PUMCH-B-046

More Information
  • Corresponding author:

    LI Kuixing, E-mail: likuixing1069@126.com

  • Received Date: June 01, 2023
  • Accepted Date: August 30, 2023
  • Available Online: December 20, 2023
  • Issue Publish Date: January 29, 2024
    Graphical Abstract
    • Abstract
  •   Objective  To investigate the incidence and adverse effects of abnormal uterine bleeding (AUB) during oral anticoagulation therapy in women with thrombophilia.
      Methods  The female patients with thrombophilia who received oral anticoagulation therapy with rivaroxaban or warfarin in the Department of Hematology of Peking Union Medical College Hospital from January 2013 to May 2023 were selected as the study subjects. Their demographic characteristics, disease related data and AUB before and after anticoagulant therapy were retrospectively collected. The patients were divided into rivaroxaban treatment group and warfarin treatment group according to anticoagulant drugs. The generalized estimating equation was used to analyze the difference in the incidence of AUB before and after anticoagulant therapy, and explore the effect of different anticoagulant therapy on AUB.
      Results  A total of 106 female patients with thrombophilia were included, and we found that oral anticoagulation significantly increased the incidence of AUB (56.6% vs. 26.4%, P < 0.001), predominantly characterized by excessive menstruation (48.1%) and prolonged periods (21.7%). Rivaroxaban was more likely to cause AUB than warfarin (OR=3.3, 95% CI: 1.5-7.4, P=0.003). Of the patients who experienced excessive menstruation and prolonged periods, 72.2%(39/54) required intervention, with suspension of anticoagulants during menstruation as the main intervention (37.0%). The patients taking rivaroxaban were more likely to stop taking them during menstruation compared to those taking warfarin (OR=10.4, 95% CI: 1.2-87.2, P=0.019).
      Conclusions  Oral anticoagulation therapy significantly increased the incidence of AUB in women with thrombophilia and the risk of AUB associated with rivaroxaban was significantly higher than that with warfarin.
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    • References (18)
  • [1]
    中华医学会血液学分会血栓与止血学组. 易栓症诊断与防治中国指南(2021年版)[J]. 中华血液学杂志, 2021, 42(11): 881-888.

    Thrombosis and Hemostasis Group, Chinese Society of Hematology, Chinese Medical Association. Chinese guidelines for diagnosis, prevention and treatment of thrombophilia (2021)[J]. Chin J Hematol, 2021, 42(11): 881-888.
    [2]
    Murin S, Marelich G P, Arroliga A C, et al. Hereditary thrombophilia and venous thromboembolism[J]. Am J Respir Crit Care Med, 1998, 158(5 Pt 1): 1369-1373.
    [3]
    唐亮, 卢惠, 胡豫. 新型口服抗凝药物在遗传性易栓症中的应用[J]. 血栓与止血学, 2022, 28(5): 1139-1145.

    Tang L, Lu H, Hu Y. The application of novel oral anticoagulants in hereditary thrombophilia[J]. Chin J Thromb Hemost, 2022, 28(5): 1139-1145.
    [4]
    Coleman C I, Turpie A G G, Bunz T J, et al. Effectiveness and safety of rivaroxaban versus warfarin in patients with provoked venous thromboembolism[J]. J Thromb Thrombolysis, 2018, 46(3): 339-345. DOI: 10.1007/s11239-018-1695-1
    [5]
    Kohn C G, Bunz T J, Beyer-Westendorf J, et al. Comparative risk of major bleeding with rivaroxaban and warfarin: population-based cohort study of unprovoked venous thromboembolism[J]. Eur J Haematol, 2019, 102(2): 143-149. DOI: 10.1111/ejh.13185
    [6]
    Dawwas G K, Dietrich E, Cuker A, et al. Effectiveness and safety of direct oral anticoagulants versus warfarin in patients with valvular atrial fibrillation: a population-based cohort study[J]. Ann Intern Med, 2021, 174(7): 910-919. DOI: 10.7326/M20-6194
    [7]
    Bryk A H, Piróg M, Plens K, et al. Heavy menstrual bleeding in women treated with rivaroxaban and vitamin K antagonists and the risk of recurrent venous thromboembolism[J]. Vascul Pharmacol, 2016, 87: 242-247. DOI: 10.1016/j.vph.2016.11.003
    [8]
    De Crem N, Peerlinck K, Vanassche T, et al. Abnormal uterine bleeding in VTE patients treated with rivaroxaban compared to vitamin K antagonists[J]. Thromb Res, 2015, 136(4): 749-753. DOI: 10.1016/j.thromres.2015.07.030
    [9]
    Ding C Y, Wang J, Cao Y, et al. Heavy menstrual bleeding among women aged 18-50 years living in Beijing, China: prevalence, risk factors, and impact on daily life[J]. BMC Womens Health, 2019, 19(1): 27. DOI: 10.1186/s12905-019-0726-1
    [10]
    Eworuke E, Hou L, Zhang R M, et al. Risk of severe abnormal uterine bleeding associated with rivaroxaban compared with apixaban, dabigatran and warfarin[J]. Drug Saf, 2021, 44(7): 753-763. DOI: 10.1007/s40264-021-01072-0
    [11]
    Weaver J, Shoaibi A, Truong H Q, et al. Comparative risk assessment of severe uterine bleeding following exposure to direct oral anticoagulants: a network study across four observational databases in the USA[J]. Drug Saf, 2021, 44(4): 479-497. DOI: 10.1007/s40264-021-01060-4
    [12]
    Samuelson Bannow B T, Chi V, Sochacki P, et al. Heavy menstrual bleeding in women on oral anticoagulants[J]. Thromb Res, 2021, 197: 114-119. DOI: 10.1016/j.thromres.2020.11.014
    [13]
    De Jong C M M, Blondon M, Ay C, et al. Incidence and impact of anticoagulation-associated abnormal menstrual bleeding in women after venous thromboembolism[J]. Blood, 2022, 140(16): 1764-1773. DOI: 10.1182/blood.2022017101
    [14]
    中华医学会妇产科学分会妇科内分泌学组. 异常子宫出血诊断与治疗指南[J]. 中华妇产科杂志, 2014, 49(11): 801-806.

    Gynecologic Endocrinology Subgroup, Chinese Society of Obstetrics and Gynecology, Chinese Medical Association. Guideline on diagnosis and treatment of abnormal uterine bleeding[J]. Chin J Obstet Gynecol, 2014, 49(11): 801-806.
    [15]
    冯力民, 夏恩兰, 丛捷, 等. 应用月经失血图评估月经血量[J]. 中华妇产科杂志, 2001, 36(1): 51.

    Feng L M, Xia E L, Cong J, et al. Applying menstrual blood loss map to evaluate menstrual blood volume[J]. Chin J Obstet Gynecol, 2001, 36(1): 51.
    [16]
    Su S S, Yang X, Su Q, et al. Prevalence and knowledge of heavy menstrual bleeding among gynecology outpatients by scanning a WeChat QR Code[J]. PLoS One, 2020, 15(4): e0229123. DOI: 10.1371/journal.pone.0229123
    [17]
    Mao L L, Xi S S, Bai W P, et al. Menstrual patterns and disorders among Chinese women of reproductive age: A cross-sectional study based on mobile application data[J]. Medicine (Baltimore), 2021, 100(16): e25329. DOI: 10.1097/MD.0000000000025329
    [18]
    Venkatesh S S, Ferreira T, Benonisdottir S, et al. Obesity and risk of female reproductive conditions: A Mendelian randomisation study[J]. PLoS Med, 2022, 19(2): e1003679. DOI: 10.1371/journal.pmed.1003679
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