DOACs seem to outperform warfarin for patients with valvular AF
Direct oral anticoagulants (DOACs) are associated with better outcomes than warfarin among patients with valvular atrial fibrillation (AF), according to a study published on March 30, 2021 in the Annals of Internal Medicine.
Although DOACs are increasingly used in place of warfarin, evidence about their effectiveness and safety in patients with valvular AF was limited.
Researchers at Perelman School of Medicine at the University of Pennsylvania, the University of Florida, and the University of Michigan performed a new-user retrospective propensity score–matched cohort study using a U.S.-based commercial health care database from January 1, 2010 to June 30, 2019. Adults with valvular AF who were newly prescribed DOACs or warfarin were included in the study. Among over 56,000 patients with valvular AF matched on propensity score, use of DOACs (vs. warfarin) was associated with lower risk for ischemic stroke or systemic embolism and major bleeding events.
The authors concluded that patients with valvular AF who were new users of DOACs had lower risks for ischemic stroke or systemic embolism and major bleeding than new users of warfarin. The results of this study may be used to guide anticoagulant choices for patients with valvular AF.