Why the study?
The study compared 1-month all-cause, major bleeding-related, and stroke-related readmissions, plus healthcare resource use and costs, among hospitalized NVAF patients treated with warfarin, rivaroxaban, or dabigatran versus apixaban.
Does apixaban reduce 1-month readmissions compared to warfarin, rivaroxaban, or dabigatran in adult patients hospitalized with nonvalvular atrial fibrillation?
Does apixaban reduce 1-month readmissions compared to warfarin, rivaroxaban, or dabigatran in adult patients hospitalized with nonvalvular atrial fibrillation?
In a real-world US cohort of hospitalized NVAF patients, apixaban was associated with lower risks of 1-month readmissions compared to warfarin and rivaroxaban.
Apixaban associated with fewer 1-month readmissions than warfarin in NVAF; extends real-world data but leaves practice change open.
Objectives To compare the risks of 1-month all-cause, major bleeding (MB)-related and stroke-related readmissions and the associated hospital resource use and costs among patients previously hospitalized for nonvalvular atrial fibrillation (NVAF) and treated with warfarin, rivaroxaban, and dabigatran vs apixaban.Methods Adult patients hospitalized with NVAF (any discharge diagnosis position) who received apixaban, warfarin, rivaroxaban, or dabigatran during hospitalization were identified from the Premier database (1 January 2013–30 June 2017) and grouped into respective cohorts. Propensity score matching was used to generate cohorts with similar characteristics. In regression analyses the risk of readmissions that occurred within 1 month of discharge were evaluated and the associated length of stay (LOS) and costs compared.Results NVAF patients treated with warfarin vs apixaban had significantly greater risk of all-cause (odds ratio [OR] = 1.05; confidence interval [CI] = 1.02–1.08; p < .001), MB-related (OR: 1.28; CI: 1.16–1.42; p < .001), and stroke-related (OR: 1.33; CI: 1.11–1.58; p = .002) readmissions; for all readmission categories, average LOS was significantly longer and costs significantly higher for warfarin treated patients. NVAF patients treated with rivaroxaban versus apixaban had significantly greater risk of all-cause (OR: 1.06; CI: 1.02–1.09; p = .001) and MB-related (OR = 1.62; CI = 1.44–1.83; p < .001) readmissions, but not stroke-related readmission; for MB-related readmissions average LOS and costs were higher for rivaroxaban treated patients. Significant differences in risks of all-cause, MB-related, and stroke-related readmissions were not observed between the apixaban and dabigatran cohorts.Conclusion In this retrospective real-world analysis of NVAF patients, apixaban treatment was associated with better clinical outcomes than warfarin or rivaroxaban and lower hospital resource burden.
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Deitelzweig et al. (2020) studied this question.
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