Key result
In adults with valvular atrial fibrillation, DOACs were associated with a lower risk of ischemic stroke or systemic embolism compared with warfarin (HR 0.64; 95% CI 0.59-0.70).
Why the study?
DOACs are increasingly used instead of warfarin, but evidence regarding their effectiveness and safety in patients with valvular AF remains limited.
Do direct oral anticoagulants reduce the risk of ischemic stroke or systemic embolism compared to warfarin in adults with valvular atrial fibrillation?
Population
56 336 adults with valvular AF
Comparison
DOACs vs warfarin
Design
Retrospective propensity score-matched cohort study
Authors
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May support DOAC preference over warfarin in valvular AF; hypothesis-generating and leaves open need for RCTs.
Cohort (n=56,336)
Do direct oral anticoagulants reduce the risk of ischemic stroke or systemic embolism compared to warfarin in adults with valvular atrial fibrillation?
Hazard Ratio: 0.64 (95% CI 0.59–0.7)
In patients with valvular atrial fibrillation, DOACs are associated with significantly lower risks of ischemic stroke, systemic embolism, and major bleeding compared to warfarin.
Dawwas et al. (2021) conducted a cohort in Valvular atrial fibrillation (n=56,336). Direct oral anticoagulants (DOACs) vs. Warfarin was evaluated on Composite of ischemic stroke or systemic embolism (HR 0.64, 95% CI 0.59 to 0.70). In adults with valvular atrial fibrillation, DOACs were associated with a lower risk of ischemic stroke or systemic embolism compared with warfarin (HR 0.64; 95% CI 0.59-0.70).
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