Which Blood Thinners Are Safer for Gastrointestinal Hemorrhage in Atrial Fibrillation?

A systematic review and meta-analysis of real-world studies examined the safety of direct oral anticoagulants (DOACs) in patients with non-valvular atrial fibrillation who experience gastrointestinal hemorrhage (GIH). Apixaban showed a lower risk of GIH compared to dabigatran, rivaroxaban, and vitamin K antagonists (VKA). Rivaroxaban was associated with an increased risk of GIH compared to dabigatran and VKA. Dabigatran had a similar GIH risk to VKA. These findings provide valuable insights for clinicians choosing the right anticoagulant for patients with atrial fibrillation at risk of GIH.