Risks for ischemic stroke or systemic embolism, major bleeding events lower with DOACs overall as a class versus warfarin<\/p>\n<\/h3>\n
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TUESDAY, March 30, 2021 (HealthDay News) — For patients who are new to therapy for valvular atrial fibrillation (AF), direct oral anticoagulants (DOACs) as a class are effective and safe compared with warfarin, with some variability among individual DOACs, according to a study published online March 30 in the Annals of Internal Medicine<\/em>.<\/p>\n Ghadeer K. Dawwas, Ph.D., from the University of Pennsylvania in Philadelphia, and colleagues examined the effectiveness and safety of DOACs compared to warfarin in a population-based cohort study involving 56,336 patients with valvular AF matched on propensity score. A composite outcome of ischemic stroke or systemic embolism was assessed as the primary effectiveness outcome, while the primary safety outcome was a composite of intracranial or gastrointestinal bleeding.<\/p>\n The researchers found that use of DOACs versus warfarin was associated with a lower risk for ischemic stroke or systemic embolism and major bleeding events (hazard ratios [95 percent confidence intervals], 0.64 [0.59 to 0.70] and 0.67 [0.63 to 0.72], respectively). These results were consistent for apixaban (hazard ratios [95 percent confidence intervals], 0.54 [0.47 to 0.61] and 0.52 [0.47 to 0.57], respectively) and for rivaroxaban (hazard ratios [95 percent confidence intervals], 0.74 [0.64 to 0.86] and 0.87 [0.79 to 0.96], respectively); for dabigatran, the results were not significant for effectiveness (hazard ratio, 1.03; 95 percent confidence interval, 0.81 to 1.31) but were significant for the major bleeding outcome (hazard ratio, 0.81; 95 percent confidence interval, 0.68 to 0.97).<\/p>\n “These real-world data suggest that patients with valvular AF who were new users of DOACs had a lower rate of ischemic stroke or systemic embolism and major bleeding than new users of warfarin,” the authors write. “These data should guide anticoagulant choices for patients with valvular AF.”<\/p>\n Several authors disclosed financial ties to the pharmaceutical industry.<\/p>\n Abstract\/Full Text (subscription or payment may be required)<\/a><\/p>\n <\/i><\/p>\n