Bhatt NR, et al. - The authors pursued an identification of the probability of visible haematuria with antithrombotic agents. Furthermore, they contemplated the correlation of urological etiology in antithrombotic-related haematuria. It was reported that the greatest risk for haematuria was found with warfarin. However, it was unlikely to cause major haematuria. On the other hand, novel antithrombotic agents commonly linked with major haematuria. The yielded data characterized the risk profile of antithrombotic agents and associated haematuria. This, in turn, assisted the clinicians with knowledge to opt for an appropriate antithrombotic agent in high-risk haematuria patients.

Methods

• As per the PRISMA guidelines, a systematic review was carried out using search engines PUBMED and SCOPUS.
• The keywords for search included “(haematuria) OR (haematuria) OR urinary bleeding)) AND ((anticoagulants) OR anticoagulation) OR noac) OR novel anticoagulants) OR antiplatelet) OR dabigatran) OR rivaroxaban) OR apixaban) OR warfarin) OR aspirin) OR heparin) OR dipyridamole)”.
• Raw data was used for the pooled analysis.
• Through the Chi-square and Logistic regression analysis, statistical analyses were performed.

Results

• The inclusion criteria was met by 22 studies describing 175,114 patients.
• It was determined that the odds ratio of haematuria with warfarin to rivoraxaban was 33 and warfarin to dabigatran was 16.
• The odds ratio of haematuria for oral anticoagulant (26.7%) to prophylactic parenteral AC (1.1%) agents was revealed to be 9.6.
• Compared to anticoagulants, antiplatelet agents exhibited 76 times lesser tendency of causing haematuria.
• Odds of haematuria with aspirin were determined to be 6.7 times odds with clopidogrel and 3.5 times odds with ticagrelor.
• Herein, 198 times greater tendency was illustrated by the dabigatran to cause major haematuria compared to warfarin.
• On the other hand, clopidogrel was 1.2 times more likely to cause major haematuria compared to aspirin.
• The findings revealed urological pathology in 44% (234/532) of the cases and malignancy was detected in 24% of the cases.