Safety and Effectiveness of Dabigatran and Other Direct Oral Anticoagulants Compared With Warfarin in Patients With Atrial Fibrillation.
Administration, Oral
Adolescent
Adult
Aged
Aged, 80 and over
Anticoagulants
/ administration & dosage
Antithrombins
/ administration & dosage
Atrial Fibrillation
/ complications
Cohort Studies
Dabigatran
/ administration & dosage
Female
Hemorrhage
/ chemically induced
Humans
Longitudinal Studies
Male
Middle Aged
Pyrazoles
/ administration & dosage
Pyridones
/ administration & dosage
Rivaroxaban
/ administration & dosage
Stroke
/ etiology
Warfarin
/ administration & dosage
Young Adult
Journal
Clinical pharmacology and therapeutics
ISSN: 1532-6535
Titre abrégé: Clin Pharmacol Ther
Pays: United States
ID NLM: 0372741
Informations de publication
Date de publication:
06 2020
06 2020
Historique:
received:
20
09
2019
accepted:
22
11
2019
pubmed:
24
12
2019
medline:
17
2
2021
entrez:
24
12
2019
Statut:
ppublish
Résumé
The study objective was to evaluate the safety and effectiveness of dabigatran and other direct oral anticoagulants (DOACs) compared with warfarin among patients with nonvalvular atrial fibrillation using a prospective monitoring program. We implemented a cohort design with propensity score matching to compare initiators of DOACs and warfarin between 2010 and 2015 in two US healthcare databases. Proportional hazards regression was used to estimate hazard ratios (HRs) for stroke and major bleeding. The final analyses included 29,448 dabigatran, 35,520 rivaroxaban, and 19,588 apixaban initiators, matched to warfarin initiators. The pooled HR for stroke was 0.75 (95% confidence interval (CI) 0.58-0.98) for dabigatran, 0.77 (95% CI 0.61-0.98) for rivaroxaban, and 0.69 (95% CI 0.50-0.96) for apixaban, consistent with findings from randomized trials. For major hemorrhage, the HRs were 0.72 (95% CI 0.65-0.80), 1.02 (95% CI 0.94-1.12), and 0.56 (95% CI 0.49-0.64), respectively, showing a decreased risk of major bleeding for both dabigatran and apixaban, as compared with trial evidence.
Substances chimiques
Anticoagulants
0
Antithrombins
0
Pyrazoles
0
Pyridones
0
apixaban
3Z9Y7UWC1J
Warfarin
5Q7ZVV76EI
Rivaroxaban
9NDF7JZ4M3
Dabigatran
I0VM4M70GC
Types de publication
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1405-1419Informations de copyright
© 2019 The Authors. Clinical Pharmacology & Therapeutics © 2019 American Society for Clinical Pharmacology and Therapeutics.
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