Key result
Initiation of apixaban (HR 0.53; 95% CI 0.39-0.71) or dabigatran (HR 0.69; 95% CI 0.50-0.96) was associated with a significantly lower risk of major bleeding compared to warfarin in NVAF patients.
Why the study?
Do NOACs (apixaban, dabigatran, rivaroxaban) reduce major bleeding compared to warfarin in newly anticoagulated NVAF patients?
Population
45,361 newly anticoagulated non-valvular atrial fibrillation patients aged ≥18 years from a US claims database
Comparison
Initiation of apixaban, dabigatran, or rivaroxaban vs Initiation of warfarin (propensity score matched)
Design
Cohort
Authors
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Findings should not yet change NVAF anticoagulation practice; extends observational comparisons but leaves randomized confirmation open.
Cohort (n=45,361)
Do NOACs (apixaban, dabigatran, rivaroxaban) reduce major bleeding compared to warfarin in newly anticoagulated NVAF patients?
Hazard Ratio: 0.53 (95% CI 0.39–0.71)
In a real-world setting of newly anticoagulated NVAF patients, apixaban and dabigatran were associated with a significantly lower risk of major bleeding compared to warfarin, whereas rivaroxaban was not.
Keshishian et al. (2016) conducted a cohort in Non-valvular atrial fibrillation (NVAF) (n=45,361). Apixaban vs. Warfarin was evaluated on Major bleeding requiring hospitalisation (HR 0.53, 95% CI 0.39-0.71). Initiation of apixaban (HR 0.53; 95% CI 0.39-0.71) or dabigatran (HR 0.69; 95% CI 0.50-0.96) was associated with a significantly lower risk of major bleeding compared to warfarin in NVAF patients.
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