Key result
In patients with acute ischemic stroke or TIA and nonvalvular atrial fibrillation, DOACs showed a similar 2-year risk of stroke or systemic embolism compared to warfarin (adjusted HR 1.07), but significantly lower risks of death and intracranial hemorrhage.
Why the study?
Do DOACs reduce stroke or systemic embolism in patients with acute ischemic stroke or TIA and nonvalvular atrial fibrillation compared to warfarin?
Population
1,116 Japanese patients with nonvalvular atrial fibrillation hospitalized within 7 days of the onset of…
Comparison
Direct oral anticoagulants including dabigatran… vs Warfarin, with target PT-INR 2.0-3.0 for…
Design
Cohort
Follow-up
median 700 days
Authors
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May favor DOACs for lower ICH and mortality in acute stroke AF; leaves open RCT confirmation of stroke prevention equivalence.
Observational (n=1,116)
Yes
Do DOACs reduce stroke or systemic embolism in patients with acute ischemic stroke or TIA and nonvalvular atrial fibrillation compared to warfarin?
Hazard Ratio: 1.07 (95% CI 0.66–1.72)
Absolute Event Rate: 8.4% vs 10.5%
In Japanese patients with acute ischemic stroke or TIA and NVAF, DOACs showed similar efficacy for preventing stroke or systemic embolism but significantly lower risks of intracranial hemorrhage and death compared to warfarin over 2 years.
Yoshimura et al. (2018) conducted an observational in Nonvalvular atrial fibrillation with acute ischemic stroke or TIA (n=1,116). Direct oral anticoagulants (DOACs) vs. Warfarin was evaluated on Stroke or systemic embolism by 2 years (HR 1.07, 95% CI 0.66-1.72). In patients with acute ischemic stroke or TIA and nonvalvular atrial fibrillation, DOACs showed a similar 2-year risk of stroke or systemic embolism compared to warfarin (adjusted HR 1.07), but significantly lower risks of death and intracranial hemorrhage.
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