Why the study?
Diabetes mellitus is an independent risk factor for chronic AF and is associated with unfavorable outcomes, prompting evaluation of DOAC efficacy and safety using a new risk index.
Do DOACs improve efficacy and safety outcomes compared to warfarin in atrial fibrillation patients with and without diabetes mellitus?
Population
AF patients with DM (n = 22,057) and 49,596 without DM from pivotal trials
Comparison
DOACs vs warfarin in patients with and without DM
Design
Systematic review
Key result
Direct oral anticoagulants had a better efficacy and safety profile than warfarin in atrial fibrillation patients with diabetes, with rivaroxaban yielding the lowest risk index for stroke (RI=0.08).
Authors
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Supports DOAC preference over warfarin in diabetic AF; extends meta-analytic evidence on rivaroxaban for stroke prevention.
Systematic Review (n=71,653)
Do DOACs improve efficacy and safety outcomes compared to warfarin in atrial fibrillation patients with and without diabetes mellitus?
DOACs are an effective and safe alternative to warfarin in atrial fibrillation patients with diabetes mellitus, with rivaroxaban demonstrating the most favorable risk index for stroke and cardiovascular death.
Acanfora et al. (2021) conducted a systematic review in Atrial fibrillation with and without diabetes mellitus (n=71,653). Direct oral anticoagulants (DOACs) vs. Warfarin was evaluated on Risk index (RI) for stroke/systemic embolism, major bleeding, and cardiovascular death. Direct oral anticoagulants had a better efficacy and safety profile than warfarin in atrial fibrillation patients with diabetes, with rivaroxaban yielding the lowest risk index for stroke (RI=0.08).