Non-Vitamin K Antagonist Oral Anticoagulants in Patients with β-Thalassemia

Abstract

Background. Patients with β-thalassemia have a high incidence of atrial fibrillation (AF) and other supraventricular arrhythmias. The use of non-vitamin K antagonist oral anticoagulants (NOACs) for thromboembolic prophylaxis in patients with β-thalassemia has not been systematically evaluated. Methods. We enrolled patients with transfusion-dependent β-thalassemia, who were on treatment with NOACs for thromboembolic prophylaxis of supraventricular arrhythmias. Data on thromboembolic and bleeding events were collected. Results. Eighteen patients were enrolled. The patients had a history of AF (sixteen), typical atrial flutter (five), and atypical atrial flutter (four). The patients were treated with dabigatran (seven), apixaban (five), rivaroxaban (four) or edoxaban (two). The mean follow-up duration was 22 ± 15 months. No thromboembolic events were reported. No major bleedings were observed. Three patients had non-major bleeding events. Two patients reported dyspepsia during treatment with dabigatran and were shifted to a different NOAC. Conclusions. Our study suggests the efficacy and safety of NOACs in patients affected by transfusion-dependent β-thalassemia.

Association between Epicardial Adipose Tissue and Atrial Fibrillation in Patients with Transfusion-Dependent β-Thalassemia

“…Anticoagulant therapy is effective in reducing thromboembolic events in patients with AF. Among patients with β-thalassemia and AF, in which chronic anemia, hepatic comorbidities, and splenectomy raised concerns of hemorrhagic complications, the use non-vitamin K oral anticoagulants has been described in small cohorts and seems safe and effective [ 21 , 22 ].…”