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Fig 1.

Study inclusion flow.

OAC, oral anticoagulant; AF, atrial fibrillation; VTE, venous thromboembolism; GI, gastrointestinal; PPI, proton pump inhibitor.

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Table 1.

Baseline characteristics of the study population.

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Fig 2.

Weighted Kaplan-Meier curves for upper gastrointestinal bleeding events according to oral anticoagulants.

NOAC, non-vitamin K antagonist oral anticoagulant.

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Fig 3.

Differential risk of upper gastrointestinal bleeding, death, and ischemic stroke in users of warfarin and 4 NOACs.

In patients on combined proton pump inhibitor and oral anticoagulant therapy, NOACs were associated with lower risk of upper gastrointestinal bleeding and mortality compared to warfarin, while there was no significant difference among the OACs in risk of stroke. *Adjusted for age, sex, atrial fibrillation, venous thromboembolism, comorbidities (hypertension, diabetes mellitus, chronic kidney disease, ischemic heart disease, heart failure, peptic ulcer disease), and concomitant use of aspirin, P2Y12 inhibitor, and nonsteroidal anti-inflammatory drug. Additionally adjusted for the CHA2DS2-VASc score. NOAC, non-vitamin K antagonist oral anticoagulant; AF, atrial fibrillation.

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Table 2.

Upper gastrointestinal bleeding risk according to OAC treatment.

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Fig 4.

Comparison of upper gastrointestinal bleeding risk in users of warfarin and 4 NOACs with consideration of dose regimens.

*IR: incidence rate per 1000 person-years. Adjusted for age, sex, atrial fibrillation, venous thromboembolism, comorbidities (hypertension, diabetes mellitus, chronic kidney disease, ischemic heart disease, heart failure, peptic ulcer disease), and concomitant use of aspirin, P2Y12 inhibitor, and nonsteroidal anti-inflammatory drug. NOAC, non-vitamin K antagonist oral anticoagulant; UGIB, upper gastrointestinal bleeding.

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Fig 5.

Upper gastrointestinal bleeding risk of NOACs with reference to warfarin in various subgroups.

*IR: incidence rate per 1000 person-years. Adjusted for age, sex, atrial fibrillation, venous thromboembolism, comorbidities (hypertension, diabetes mellitus, chronic kidney disease, ischemic heart disease, heart failure, peptic ulcer disease), and concomitant use of aspirin, P2Y12 inhibitor, and nonsteroidal anti-inflammatory drug. NOAC, non-vitamin K antagonist oral anticoagulant; NSAID, nonsteroidal anti-inflammatory drug; NVAF, non-valvular atrial fibrillation; UGIB, upper gastrointestinal bleeding; VTE, venous thromboembolism.

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Table 3.

Risk of death according to OAC treatment.

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Table 4.

Risk of stroke according to OAC treatment in patients with atrial fibrillation.

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