Key result
DOACs were associated with lower risks of 365-day readmission for cerebral infarction (SHR 0.76; 95% CI 0.71-0.81) and bleeding events (SHR 0.78; 95% CI 0.68-0.90) compared to warfarin.
Why the study?
Whether DOACs are more effective and safer than warfarin for secondary prevention of cerebral infarction in older patients with AF remains unclear.
Do direct oral anticoagulants reduce the risk of recurrent cerebral infarction and bleeding events compared to warfarin in adults aged ≥75 years with atrial fibrillation and prior cerebral infarction?
Population
101,389 patients aged ≥75 years with AF hospitalized for cerebral infarction
Comparison
DOACs vs warfarin after discharge
Design
Retrospective nationwide database study using propensity score-stabilized IPTW
Follow-up
365 days
Authors
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DOACs associated with lower reinfarction and bleeding risks vs warfarin in elderly post-stroke AF; leaves open need for confirmatory RCTs.
Cohort (n=101,389)
Yes
Do direct oral anticoagulants reduce the risk of recurrent cerebral infarction and bleeding events compared to warfarin in adults aged ≥75 years with atrial fibrillation and prior cerebral infarction?
Hazard Ratio: 0.76 (95% CI 0.71–0.81)
In older adults (≥75 years) with atrial fibrillation and a history of cerebral infarction, DOACs are associated with significantly lower risks of recurrent cerebral infarction and bleeding compared to warfarin.
Kumazawa et al. (2022) conducted a cohort in Atrial fibrillation with history of cerebral infarction (n=101,389). Direct oral anticoagulants (DOACs) vs. Warfarin was evaluated on 365-day readmission for cerebral infarction or bleeding events (SHR 0.76, 95% CI 0.71-0.81). DOACs were associated with lower risks of 365-day readmission for cerebral infarction (SHR 0.76; 95% CI 0.71-0.81) and bleeding events (SHR 0.78; 95% CI 0.68-0.90) compared to warfarin.
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