Non Vitamin K Antagonist Oral Anticoagulants in Atrial Fibrillation Patients Scheduled for Electrical Cardioversion: A Real-Life Propensity Score Matched Study

The aim of the present study was to assess the safety and effectiveness of non-vitamin K antagonist oral anticoagulants (NOACs) versus vitamin K antagonists (VKAs) in atrial fibrillation (AF) patients undergoing electrical cardioversion (EC). A propensity score-matched analysis was performed in orde...

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Bibliographic Details
Published in:Journal of blood medicine 2021-01, Vol.12, p.413-420
Main Authors: Rago, Anna, Pezzullo, Enrica, Malvezzi Caracciolo d'Aquino, Marco, Scognamiglio, Gabriella, Caso, Valentina Maria, Martone, Francesco, Attena, Emilio, Parisi, Valentina, D'Onofrio, Antonio, Golino, Paolo, Nigro, Gerardo, Russo, Vincenzo
Format: Article
Language:English
Subjects:
Analysis
Anticoagulants
Anticoagulants (Medicine)
Atrial fibrillation
Cardiac arrhythmia
Cardioversion
Care and treatment
Electric countershock
Embolisms
Heart attacks
Ischemia
Mortality
Original Research
Patients
Stroke
Stroke (Disease)
Thromboembolism
Thrombosis
Transient ischemic attack
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Summary:The aim of the present study was to assess the safety and effectiveness of non-vitamin K antagonist oral anticoagulants (NOACs) versus vitamin K antagonists (VKAs) in atrial fibrillation (AF) patients undergoing electrical cardioversion (EC). A propensity score-matched analysis was performed in order to identify two homogeneous groups including AF patients on NOACs and VKAs treatment scheduled for EC. The primary safety endpoint was major bleeding. The composite of stroke, transient ischemic attack (TIA) and systemic embolism (SE) was the primary effectiveness endpoint. The discontinuation rate of anticoagulant therapy was assessed. A total of 495 AF patients on NOACs therapy and scheduled for EC were compared to 495 VKAs recipients. No statistically significant differences in the incidence of both major bleeding (1.01% versus 1.4%; = 0.5) and thromboembolic events (0.6% versus 0.8%; = 0.7) were observed during a mean follow-up of 15 ± 3 months. The discontinuation rate of NOACs was significantly lower compared to VKAs (1.6% versus 3.6%, =0.04). We showed a safe and effective clinical profile of NOACs among AF patients scheduled for electrical cardioversion in real-life setting. Patients on NOACs therapy showed a lower discontinuation rate compared to those on VKAs.
ISSN:1179-2736
1179-2736
DOI:10.2147/JBM.S299265