Direct Oral Anticoagulants Versus Warfarin in Patients With Atrial Fibrillation and Valve Replacement or Repair

Background We sought to examine outcomes of direct oral anticoagulants (DOACs) versus warfarin in atrial fibrillation with valve repair/replacement. Methods and Results Two atrial fibrillation cohorts from Medicare were identified from 2015 to 2019. They comprised patients who underwent surgical or...

Full description

Saved in:
Bibliographic Details
Published in:Journal of the American Heart Association 2022-09, Vol.11 (17), p.e026666
Main Authors: Mentias, Amgad, Saad, Marwan, Michael, Madonna, Nakhla, Shady, Menon, Venu, Harb, Serge, Chaudhury, Pulkit, Johnston, Douglas, Saliba, Walid, Wazni, Oussama, Svensson, Lars, Desai, Milind Y, Kapadia, Samir
Format: Article
Language:English
Subjects:
Administration, Oral
Aged
Anticoagulants - adverse effects
apixaban
atrial fibrillation
Atrial Fibrillation - complications
Atrial Fibrillation - diagnosis
Atrial Fibrillation - drug therapy
brain ischemia
dabigatran
Dabigatran - adverse effects
Hemorrhage - chemically induced
Hemorrhage - epidemiology
Humans
Ischemic Stroke
Medicare
mitral valve
Pyridones - therapeutic use
rivaroxaban
Rivaroxaban - therapeutic use
Stroke - epidemiology
Stroke - etiology
Stroke - prevention & control
United States - epidemiology
Warfarin - adverse effects
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background We sought to examine outcomes of direct oral anticoagulants (DOACs) versus warfarin in atrial fibrillation with valve repair/replacement. Methods and Results Two atrial fibrillation cohorts from Medicare were identified from 2015 to 2019. They comprised patients who underwent surgical or transcatheter mitral valve repair (MV repair cohort) and surgical aortic or mitral bioprosthetic or transcatheter aortic valve replacement (bioprosthetic cohort). Each cohort was divided into warfarin and DOACs (apixaban, rivaroxaban, and dabigatran) groups. Study outcomes included mortality, stroke, and major bleeding. Inverse probability weighting was used for adjustment between the 2 groups in each cohort. The MV repair cohort included 1178 patients. After a median of 468 days, DOACs were associated with lower risk of mortality (hazard ratio [HR], 0.67 [95% CI, 0.55-0.82],
ISSN:2047-9980
2047-9980
DOI:10.1161/JAHA.122.026666