What does this research mean for the field?

In patients with atrial fibrillation, warfarin treatment with an effective time in therapeutic range (>60%) provides similar long-term efficacy and safety outcomes, including rates of ischemic events, intracranial bleeding, and mortality, compared to non-vitamin K antagonist oral anticoagulants (NOACs). Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

February 28, 2023Kardiologia PolskaOpen Access

Comparison of the real-life clinical outcomes of warfarin with effective time in therapeutic range and non-vitamin K antagonist oral anticoagulants: Insight from the AFTER-2 trial

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Why the study?

It is unclear whether warfarin treatment with high time in therapeutic range is as effective and safe as non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation.

Does warfarin with effective TTR (>60%) provide similar long-term efficacy and safety compared to NOACs in patients with non-valvular atrial fibrillation?

Population

1140 patients with AF followed at 35 different centers

Comparison

Warfarin with effective TTR (>60%) vs NOACs

Design

Multicenter observational study

Follow-up

five years

Authors

AAAdem AktanMardin Artuklu University TGTuncay GüzelSağlık Bilimleri Üniversitesi BABurhan AslanBursa Technical University

Discussion

Member takes

Implication

Effective TTR warfarin showed similar outcomes to NOACs in this cohort; leaves open whether it remains a viable alternative in non-valvular AF.

Structured PICO

Does warfarin with effective TTR (>60%) provide similar long-term efficacy and safety compared to NOACs in patients with non-valvular atrial fibrillation?

Population

1,140 adults (>18 years) with non-valvular atrial fibrillation (excluding prosthetic heart valves and rheumatic mitral valve stenosis), mean age 69.4, 57% female, from Turkey. Excluded patients with TTR <60% or switching between oral anticoagulants.

Intervention

Vitamin K antagonists (warfarin) with effective time in therapeutic range (TTR >60%)

Comparator

Non-vitamin K antagonist oral anticoagulants (NOACs: dabigatran, rivaroxaban, apixaban, edoxaban)

Outcome

Ischemic cerebrovascular disease/transient ischemic attack (CVD/TIA), intracranial bleeding, and mortality based on one-year and five-year follow-upshard clinical

In real-world patients with atrial fibrillation, warfarin therapy with an effective time in therapeutic range (>60%) provides similar long-term efficacy and safety outcomes compared to NOACs.

Cite This Study

Aktan et al. (2023) studied this question.

synapsesocial.com/papers/6a198d2a8774b0e946debc8e https://doi.org/10.33963/kp.a2022.0287

Topics

Atrial fibrillation Anticoagulation in AF Persistent AF management

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Implication

Effective TTR warfarin showed similar outcomes to NOACs in this cohort; leaves open whether it remains a viable alternative in non-valvular AF.

Comparison of the real-life clinical outcomes of warfarin with effective time in therapeutic range and non-vitamin K antagonist oral anticoagulants: Insight from the AFTER-2 trial

Discussion

Member takes

Implication

Structured PICO

Cite This Study

Topics

Comparison of the real-life clinical outcomes of warfarin with effective time in therapeutic range and non-vitamin K antagonist oral anticoagulants: Insight from the AFTER-2 trial

Discussion

Member takes

Implication

Structured PICO

Cite This Study

Also Consider

Topics

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