Key result
NOACs were associated with a higher risk of major bleeding compared with VKAs (HR 2.07; 95% CI 1.27-3.38), primarily driven by gastrointestinal bleeding in women.
Why the study?
Does the use of NOACs or aspirin compared to VKAs affect the risk of major bleeding and stroke in patients with atrial fibrillation?
Population
31,497 patients with atrial fibrillation who were new users of vitamin K antagonists, nonvitamin K…
Comparison
Nonvitamin K antagonist oral anticoagulants or… vs Vitamin K antagonists (VKAs)
Design
Cohort
Authors
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May warrant caution with NOACs in women; leaves open need for randomized confirmation.
Cohort (n=31,497)
Does the use of NOACs or aspirin compared to VKAs affect the risk of major bleeding and stroke in patients with atrial fibrillation?
Hazard Ratio: 2.07 (95% CI 1.27–3.38)
In a real-world cohort of AF patients, NOACs showed similar efficacy to VKAs for stroke prevention but were associated with a higher risk of gastrointestinal bleeding, particularly in women.
Gieling et al. (2017) conducted a cohort in atrial fibrillation (n=31,497). NOACs vs. VKAs was evaluated on major bleeding (HR 2.07, 95% CI 1.27-3.38). NOACs were associated with a higher risk of major bleeding compared with VKAs (HR 2.07; 95% CI 1.27-3.38), primarily driven by gastrointestinal bleeding in women.
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