Key result
Rising DOAC use coincides with a ~26% drop in stroke and systemic embolism.
Why the study?
Does the increasing use of direct oral anticoagulants over time correlate with reduced stroke/systemic embolism and major bleeding in Medicare beneficiaries with non-valvular atrial fibrillation?
Cohort (n=7,071,202)
Does the increasing use of direct oral anticoagulants over time correlate with reduced stroke/systemic embolism and major bleeding in Medicare beneficiaries with non-valvular atrial fibrillation?
Absolute Event Rate: 1.4% vs 1.9%
The progressive uptake of DOACs between 2013 and 2016 in the US Medicare population coincided with significant reductions in stroke, major bleeding, and total healthcare costs, though overall OAC underutilization remains high.
No takes yet. Share an insight, caveat, or question.
Increased DOAC use was associated with lower stroke rates in Medicare AF; leaves open causality and need for confirmation.
Atwater et al. (2023) conducted a cohort in Non-valvular atrial fibrillation (n=7,071,202). Direct oral anticoagulants (DOACs) vs. Warfarin (temporal trend 2013-2016) was evaluated on Incidence of stroke/systemic embolism (events per 100 person-years). Between 2013 and 2016, direct oral anticoagulant use increased from 21% to 48% among treated patients, coinciding with a decrease in stroke/systemic embolism from 1.9 to 1.4 events per 100 person-years.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: