Key result
Apixaban, dabigatran, and rivaroxaban were associated with lower risks of ischemic stroke or systemic embolism compared with warfarin (HRs 0.55, 0.82, and 0.81, respectively) in Asian patients.
Why the study?
Do non-vitamin K antagonist oral anticoagulants (apixaban, dabigatran, rivaroxaban) reduce ischemic stroke/systemic embolism, major bleeding, and mortality compared to warfarin in Asian patients with nonvalvular atrial fibrillation?
Population
73,074 Asian patients with nonvalvular atrial fibrillation from the Taiwan National Health Insurance…
Comparison
Non-vitamin K antagonist oral anticoagulants at… vs Warfarin
Design
Cohort
Follow-up
Until the first occurrence of any efficacy or safety…
Authors
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Supports lower IS/SE risk with NOACs vs warfarin in Asian AF; extends real-world data but leaves practice change open pending RCTs.
Cohort (n=73,074)
Yes
Do non-vitamin K antagonist oral anticoagulants (apixaban, dabigatran, rivaroxaban) reduce ischemic stroke/systemic embolism, major bleeding, and mortality compared to warfarin in Asian patients with nonvalvular atrial fibrillation?
Effect estimate: HR 0.55 (apixaban), 0.82 (dabigatran), 0.81 (rivaroxaban) (95% CI 0.43-0.69, 0.68-0.98, 0.67-0.97)
In a large real-world Asian cohort, NOACs (apixaban, dabigatran, and rivaroxaban) were associated with significantly lower risks of ischemic stroke, major bleeding, and mortality compared to warfarin.
Chan et al. (2018) conducted a cohort in nonvalvular atrial fibrillation (n=73,074). Apixaban, dabigatran, rivaroxaban vs. Warfarin was evaluated on ischemic stroke/systemic embolism (IS/SE) (HR 0.55 (apixaban), 0.82 (dabigatran), 0.81 (rivaroxaban), 95% CI 0.43-0.69, 0.68-0.98, 0.67-0.97). Apixaban, dabigatran, and rivaroxaban were associated with lower risks of ischemic stroke or systemic embolism compared with warfarin (HRs 0.55, 0.82, and 0.81, respectively) in Asian patients.
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