Key result
In octogenarians with non-valvular atrial fibrillation, NOACs and warfarin had similar incidence of stroke or systemic embolism (p=0.862) and major bleeding (p=0.824) over 302.7 patient-years.
Why the study?
Data about the use of oral anticoagulants among patients aged 80 years or older with non-valvular AF remain limited.
Do non-vitamin K antagonist oral anticoagulants reduce stroke/systemic embolism or major bleeding compared to well-controlled warfarin in octogenarians with non-valvular atrial fibrillation?
Cohort (n=322)
No
Do non-vitamin K antagonist oral anticoagulants reduce stroke/systemic embolism or major bleeding compared to well-controlled warfarin in octogenarians with non-valvular atrial fibrillation?
p-value: p=0.862
NOACs and well-controlled warfarin demonstrate similar efficacy and safety profiles in octogenarians with non-valvular atrial fibrillation in a real-world setting.
Supports cautious OAC selection in octogenarians with NVAF; extends limited observational data but leaves open need for RCTs.
OBJECTIVE: Atrial fibrillation (AF) is the most common arrhythmia in clinical practice, and its prevalence increases with age. Nevertheless, data about the use of oral anticoagulants (OACs) among patients with ≥80 years remains limited. This study aimed to evaluate the efficacy and safety of non-vitamin K antagonist oral anticoagulants (NOACs) and warfarin in octogenarians with non-valvular AF (NVAF). METHODS: Medical records of 387 patients who were ≥80 years and diagnosed with NVAF in our hospital between January 2017 and December 2019 were evaluated retrospectively. Patients with NVAF were divided into 2 groups (NOACs and warfarin), and the incidence of stroke/systemic embolism and major bleeding were analyzed. RESULTS: A total of 322 patients were included in the study. The median follow-up duration was 10.9 months for the NOACs group and 12.1 months for the warfarin group. The primary efficacy outcome was stroke/systemic embolism, and the primary safety outcome was major bleeding. A total of 220 patients were taking NOACs, and the most preferred NOACs were apixaban (53.6%), rivaroxaban (29.5%), dabigatran (13.2%), and edoxaban (3.6%) in this order. During a mean follow-up of 302.7 patient-years, the incidence of stroke or systemic embolic events was slightly higher among patients with warfarin but the difference was not statistically significant (p=0.862). The incidence rates of major bleeding events were similar between the treatment groups (p=0.824). CONCLUSION: Our study revealed that the safety and efficacy outcomes are similar between the 2 treatment groups in octogenarians with NVAF.
No takes yet. Share an insight, caveat, or question.
Akgün et al. (2021) conducted a cohort in Non-valvular atrial fibrillation (n=322). Non-vitamin K antagonist oral anticoagulants (NOACs) vs. Warfarin was evaluated on Stroke or systemic embolism (p=0.862). In octogenarians with non-valvular atrial fibrillation, NOACs and warfarin had similar incidence of stroke or systemic embolism (p=0.862) and major bleeding (p=0.824) over 302.7 patient-years.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: