Direct Oral Anticoagulants Prove Safer Efficacy Than Warfarin

Direct oral anticoagulants (DOACs) have immediately become alluring options in contrast to the long‐standing standard of care in anticoagulation.

It was found that almost 56,000 patients with valvular atrial fibrillation in the United States who were new users of direct oral anticoagulants (DOACs) had lower risks for ischemic stroke or systemic embolism and major bleeding events, compared with new users of warfarin as per a study at the Perelman School of Medicine, the University of Pennsylvania, published in Annals of Internal Medicine.

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‘Patients with valvular atrial fibrillation who are new users of direct oral anticoagulants (DOACs) have lower risks for ischemic stroke or systemic embolism and major bleeding events when compared with new users of warfarin. These discoveries should be thus assisted with controlling anticoagulant decisions for patients with valvular atrial fibrillation. ’

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Warfarin is a drug that is commonly called a "blood thinner". It maintains the smooth blood flow in your body by decreasing the number of certain substances (clotting proteins) in your blood. It has been the mainstay therapy to prevent stroke, but drawbacks include a narrow therapeutic window, dose-response variability, and many interactions with drugs and food.

Direct oral anticoagulants (DOACs) are said to have similar or superior antithrombotic effects to warfarin and lower bleeding risk, according to randomized clinical trials. While DOACs are increasingly being used in place of warfarin, evidence about their effectiveness and safety in patients with valvular atrial fibrillation remains limited.

Direct Oral Anticoagulants and Warfarin

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The research team utilized the data from a practice-based commercial healthcare database to assess the safety and effectiveness of DOAC against warfarin for adults with valvular atrial fibrillation who were newly prescribed either medication.

The primary effectiveness outcome was a composite of ischemic stroke or systemic embolism. The primary safety outcome was a composite of intracranial or gastrointestinal bleeding.

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It was found that among a total of 56,336 patients matched on propensity score, use of DOACs was associated with greater effectiveness defined by the study endpoint compared with warfarin with fewer major bleeding events.

These results were consistent for apixaban and rivaroxaban . With dabigatran, results were consistent for major bleeding, but now for effectiveness. The study thereby suggests that these discoveries should be assisted with controlling anticoagulant decisions for patients with valvular atrial fibrillation.

Source-Medindia