Why the study?
Limited evidence is available regarding the comparative effectiveness and safety of DOACs versus warfarin and DOACs versus DOACs in non-valvular atrial fibrillation patients with heart failure.
Do direct oral anticoagulants (apixaban, dabigatran, rivaroxaban) reduce stroke/systemic embolism, major bleeding, and MACE compared to warfarin in older adults with non-valvular atrial fibrillation and heart failure?
Population
US Medicare enrollees with non-valvular atrial fibrillation and heart failure initiating DOACs or warfarin
Comparison
DOACs (apixaban, rivaroxaban, dabigatran) vs warfarin and DOACs vs DOACs
Design
Propensity score-matched retrospective cohort study
Authors
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Apixaban may lower stroke, bleeding, and MACE risks versus warfarin in elderly NVAF-HF patients; leaves open need for randomized confirmation before practice change.
Do direct oral anticoagulants (apixaban, dabigatran, rivaroxaban) reduce stroke/systemic embolism, major bleeding, and MACE compared to warfarin in older adults with non-valvular atrial fibrillation and heart failure?
In older adults with NVAF and HF, apixaban was associated with lower risks of stroke/systemic embolism, major bleeding, and MACE compared to warfarin, while rivaroxaban and dabigatran showed varying safety and effectiveness profiles.
García et al. (2019) studied this question.
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