Do reduced dose non-vitamin K antagonist oral anticoagulants reduce ischaemic stroke/systemic embolism and bleeding in patients with atrial fibrillation compared with warfarin?
In patients with atrial fibrillation, reduced-dose NOACs showed no significant difference in thromboembolic events compared to warfarin, while dabigatran 110 mg twice daily significantly reduced bleeding.
In this propensity weighted nationwide study of reduced dose non-vitamin K antagonist oral anticoagulant regimens, apixaban 2.5 mg twice a day was associated with a trend towards higher rates of ischaemic stroke/systemic embolism compared with warfarin, while rivaroxaban 15 mg once a day and dabigatran 110 mg twice a day showed a trend towards lower thromboembolic rates. The results were not significantly different. Rates of bleeding (the principal safety outcome) were significantly lower for dabigatran, but not significantly different for apixaban and rivaroxaban compared with warfarin.
Nielsen et al. (Fri,) studied this question.