AI Article Synopsis
- This study investigates the real-world risks of stroke/systemic embolism (SE) and major bleeding (MB) among patients with non-valvular atrial fibrillation (NVAF) who switch from warfarin to direct oral anticoagulants (DOACs) like apixaban, dabigatran, and rivaroxaban.
- Data was collected from U.S. commercial claims databases between 2012 and 2019, focusing on NVAF patients switching from warfarin to DOACs within 90 days, and employing statistical models to assess risks.
- Findings suggest that apixaban offers a significantly lower risk of stroke/SE and MB compared to dabigatran, while having a similar
Article Abstract
Introduction: There is a paucity of real-world studies examining the risks of stroke/systemic embolism (SE) and major bleeding (MB) among non-valvular atrial fibrillation (NVAF) patients switching from warfarin to a direct oral anticoagulant (DOAC). This retrospective study was conducted to compare the stroke/SE and MB risks between patients switched from warfarin to apixaban, dabigatran, or rivaroxaban in real-world clinical practice.
Materials And Methods: This study used data from four United States commercial claims databases from January 1, 2012 to June 30, 2019. The study population included NVAF patients initially treated with warfarin and switched to apixaban, dabigatran, or rivaroxaban within 90 days of their warfarin prescription ending. Patients were matched 1:1 between the DOACs in each database using propensity scores and then pooled for the final analysis. Cox proportional hazards models were used to calculate the risk of stroke/SE and MB.
Results And Conclusions: The final population consisted of 2,611 apixaban-dabigatran, 12,165 apixaban-rivaroxaban, and 2,672 dabigatran-rivaroxaban pairs. Apixaban vs. dabigatran was associated with a lower risk of stroke/SE (hazard ratio [HR]: 0.61; 95% confidence interval [CI]: 0.39-0.96) and MB (HR: 0.67; 95% CI: 0.50-0.91). Apixaban vs. rivaroxaban was associated with a similar risk of stroke/SE (HR: 0.88; 95% CI: 0.73-1.07) and a lower risk of MB (HR: 0.60; 95% CI: 0.52-0.68). There was no significant difference in either risk between dabigatran and rivaroxaban. These results provide important insights into how the risks of stroke/SE and MB for NVAF patients vary when switching from warfarin to different DOACs.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11315758 | PMC |
| http://dx.doi.org/10.1007/s11239-024-02976-1 | DOI Listing |
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