Key result
Compared with warfarin, major bleeding risk was lower with dabigatran (HR 0.67; 95% CI 0.60-0.76) and apixaban (HR 0.52; 95% CI 0.41-0.67), but similar with rivaroxaban in patients with NVAF.
Why the study?
Do non-vitamin K oral anticoagulants (dabigatran, apixaban, rivaroxaban) reduce major bleeding compared to warfarin in patients with nonvalvular atrial fibrillation?
Population
44,057 patients with nonvalvular atrial fibrillation in a commercially insured population in the United…
Comparison
Non-vitamin K oral anticoagulants vs Warfarin
Design
Cohort
Follow-up
36,636.2 person-years of follow-up
Authors
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Apixaban and dabigatran were associated with lower bleeding risk than warfarin in NVAF; extends real-world data but leaves practice change to RCTs.
Cohort (n=44,057)
Do non-vitamin K oral anticoagulants (dabigatran, apixaban, rivaroxaban) reduce major bleeding compared to warfarin in patients with nonvalvular atrial fibrillation?
Hazard Ratio: 0.67 (95% CI 0.6–0.76)
Absolute Event Rate: 2.8% vs 6%
In a real-world cohort of NVAF patients, apixaban and dabigatran were associated with lower major bleeding risk compared to warfarin, while rivaroxaban had a similar risk to warfarin.
Adeboyeje et al. (2017) conducted a cohort in Nonvalvular atrial fibrillation (n=44,057). Dabigatran, apixaban, or rivaroxaban vs. Warfarin was evaluated on Time to first major bleeding event requiring hospitalization (HR 0.67, 95% CI 0.60-0.76). Compared with warfarin, major bleeding risk was lower with dabigatran (HR 0.67; 95% CI 0.60-0.76) and apixaban (HR 0.52; 95% CI 0.41-0.67), but similar with rivaroxaban in patients with NVAF.
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