In patients with atrial fibrillation, gastrointestinal surgery significantly increased ischemic stroke risk among warfarin users but not DOAC users, with DOACs demonstrating a lower stroke risk than warfarin after surgery (aHR 0.35).
Cohort (n=388,214)
Sí
Does direct oral anticoagulant use compared to warfarin reduce ischemic stroke and safety outcomes in atrial fibrillation patients who have undergone gastrointestinal surgery?
DOACs maintain a favorable efficacy and safety profile compared to warfarin in patients with atrial fibrillation who undergo gastrointestinal surgery, avoiding the increased ischemic stroke risk seen with warfarin post-surgery.
Estimación del efecto: aHR 0.35 (95% CI 0.17-0.72)
Tasa de eventos absoluta: 1.61% vs 4.84%
In AF patients, GI surgery significantly increased ischemic stroke risk among warfarin users, but not among DOAC users. DOACs showed generally favorable profiles after GI surgery and may remain a reasonable anticoagulant, with potentially more favorable profile after upper GI surgery.
Ha et al. (Thu,) conducted a cohort in Atrial fibrillation (n=388,214). Direct oral anticoagulants (DOACs) vs. Warfarin was evaluated on Ischemic stroke (in patients with prior gastrointestinal surgery) (aHR 0.35, 95% CI 0.17-0.72). In patients with atrial fibrillation, gastrointestinal surgery significantly increased ischemic stroke risk among warfarin users but not DOAC users, with DOACs demonstrating a lower stroke risk than warfarin after surgery (aHR 0.35).