Key result
NOACs were associated with a lower risk of developing diabetes requiring treatment than warfarin in patients with atrial fibrillation.
Why the study?
To compare the risk of diabetes development in patients with AF treated with NOACs versus warfarin.
Do NOACs reduce the risk of incident diabetes compared to warfarin in adult patients with new-onset atrial fibrillation?
Cohort (n=10,746)
Yes
Do NOACs reduce the risk of incident diabetes compared to warfarin in adult patients with new-onset atrial fibrillation?
In patients with new-onset atrial fibrillation, the use of NOACs is associated with a significantly lower risk of developing incident diabetes compared to warfarin, particularly in older patients and those with good medication adherence.
Answers are grounded in this paper and cite their sources.
NOAC use was associated with lower diabetes risk in older AF patients; leaves open whether this warrants prospective trials before practice consideration.
AIM: To compare the risk of diabetes development in patients with atrial fibrillation (AF) treated with non-vitamin K antagonist oral anticoagulants (NOACs) and warfarin. MATERIALS AND METHODS: We conducted a nationwide retrospective cohort study using Taiwan's National Health Insurance Research Database. Adult patients with new onset of AF, treated with NOACs or warfarin between 2012 and 2016, were included. The NOAC cohort was further divided into dabigatran, rivaroxaban and apixaban groups. The primary outcome was incident diabetes requiring treatment with antidiabetic drugs. Fine and Gray subdistribution hazards models were used to estimate the adjusted hazard ratio (aHR). Propensity score matching was performed for each head-to-head comparison. RESULTS: A total of 10 746 new-onset AF patients were included in our study. During the mean 2.4-year follow-up, NOACs were associated with a lower risk of developing diabetes than warfarin (aHR = 0.80, 95% confidence interval [CI]: 0.68-0.94, P = .007). Subgroup analyses confirmed that dabigatran, rivaroxaban and apixaban each had a reduced diabetes risk. Stratified analyses showed that the lower risk of diabetes associated with NOAC treatment was specific to patients aged 65 years or older (aHR = 0.74, 95% CI: 0.62-0.89, P = .002) and those with good medication adherence (aHR = 0.70, 95% CI: 0.58-0.84, P < .001). CONCLUSIONS: Taking an NOAC was associated with a lower risk of developing diabetes than taking warfarin in patients with AF.
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Huang et al. (2020) conducted a cohort in atrial fibrillation (n=10,746). non-vitamin K antagonist oral anticoagulants (NOACs) vs. warfarin was evaluated on incident diabetes requiring treatment with antidiabetic drugs (aHR 0.80, 95% CI 0.68-0.94, p=.007). NOACs were associated with a lower risk of developing diabetes requiring treatment than warfarin in patients with atrial fibrillation.
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