Key result
Oral anticoagulants effectively prevent stroke in patients with atrial fibrillation, reducing the relative risk by 62% compared to placebo based on cited meta-analysis data.
Why the study?
Do oral anticoagulants reduce the risk of stroke and thromboembolic complications in patients with atrial fibrillation and diabetes mellitus?
Do oral anticoagulants reduce the risk of stroke and thromboembolic complications in patients with atrial fibrillation and diabetes mellitus?
Direct oral anticoagulants, particularly rivaroxaban, are effective and safe alternatives to warfarin for stroke prevention in patients with concurrent atrial fibrillation and diabetes mellitus, offering potential renal protective benefits.
Supports oral anticoagulation for stroke prevention in atrial fibrillation with diabetes; extends meta-analyses but leaves optimal agents open.
Atrial fibrillation is one of the most common concomitant diseases in patients with diabetes mellitus (DM). Meta-analyses of multiple studies have shown that the risk of AF is higher for diabetic patients with impaired glucose homeostasis than for patients without DM. Patients with AF and DM were younger, more frequently had arterial hypertension, chronic kidney disease, heart failure, and ischemic heart disease, and stroke and were characterized with a more severe course of AF. The article discusses possible mechanisms of the mutually aggravating effects of DM and AF, scales for evaluating the risk of bleeding (CHADS2, CHA2DS2‑VASc, HAS-BLED), and the role of anticoagulants. A meta-analysis of 16 randomized clinical studies, including 9 874 patients, has demonstrated the efficacy of oral anticoagulants in prevention of stroke with an overall decrease in the relative risk by 62 % compared to placebo (95% confidence interval, from 48 to 72 ). For prevention of complications in patients with AF and DM, current antithrombotic therapies can be used, specifically the oral factor Xa inhibitor, rivaroxaban, which is the best studied in patients with AF and DM and represents a possible alternative to warfarin in such patients.
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Обрезан et al. (2020) conducted a review in Atrial Fibrillation and Diabetes Mellitus. Oral anticoagulants (e.g., Rivaroxaban) vs. Warfarin or Placebo was evaluated. Oral anticoagulants effectively prevent stroke in patients with atrial fibrillation, reducing the relative risk by 62% compared to placebo based on cited meta-analysis data.
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