PT  - JOURNAL ARTICLE
AU  - Johannes Lagethon Bjørnstad
AU  - Adil Mahboob Khan
AU  - Henriette Røed-Undlien
AU  - Bjørn Bendz
AU  - Ståle Nygård
AU  - Tom Nilsen Hoel
AU  - Per Snorre Lingaas
TI  - Operative survival in patients with acute aortic disease in the era of newer oral anticoagulants
AID  - 10.1136/openhrt-2020-001278
DP  - 2020 Jul 01
TA  - Open Heart
PG  - e001278
VI  - 7
IP  - 2
4099  - http://openheart.bmj.com/content/7/2/e001278.short
4100  - http://openheart.bmj.com/content/7/2/e001278.full
SO  - Open Heart2020 Jul 01; 7
AB  - Aims The aim of this study was the analysis of the risk associated with direct oral anticoagulants (DOACs) in patients undergoing non-elective operations on the proximal aorta due to aortic disease.Methods and results Data from the department’s register of cardiac surgery was analysed retrospectively with emphasis on operative mortality. 135 non-elective operations for proximal aortic disease (October 2016 to 2018) were identified, of which 19 died during the first 90 days. DOAC use was the top-ranked risk factor in the univariate analysis with a HR of 9.6 (3.1 to 29), p=0.00007. Using a Cox proportional hazards model including the most relevant risk factors, the risk associated with DOAC use remained significant with a HR of 6.1 (1.4 to 26.3), p=0.015. We did not find increased risk associated with warfarin use.Conclusion In patients undergoing non-elective operations on the proximal aorta due to aortic disease, the use of DOAC is associated with increased operative mortality.