Real-world bleeding risk and molecular interaction profiles of direct oral anticoagulants: a comparative study integrating clinical outcomes and in silico docking

BackgroundDifferences in bleeding risk among direct oral anticoagulants (DOACs) may reflect not only exposure-related factors but also molecule-specific drug–target interaction characteristics. This study aimed to evaluate real-world bleeding outcomes and to complement these findings with molecular docking analyses as supportive, hypothesis-generating mechanistic context for safety differences among factor Xa inhibitors and a direct thrombin inhibitor.MethodsA retrospective cohort of 5,721 patie