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Frailty and Clinical Outcomes of Direct Oral Anticoagulants Versus Warfarin in Older Adults With Atrial Fibrillation : A Cohort Study
CONCLUSION: For older adults with AF, apixaban was associated with lower rates of adverse events across all frailty levels. Dabigatran and rivaroxaban were associated with lower event rates only among nonfrail patients.PRIMARY FUNDING SOURCE: National Institute on Aging.PMID:34280330 | DOI:10.7326/M20-7141
Source: Annals of Internal Medicine - July 19, 2021 Category: Internal Medicine Authors: Dae Hyun Kim Ajinkya Pawar Joshua J Gagne Lily G Bessette Hemin Lee Robert J Glynn Sebastian Schneeweiss Source Type: research

Predictors of bleeding event among elderly patients with mechanical valve replacement using random forest model: A retrospective study
Available classification tools and risk factors predicting bleeding events in elderly patients after mechanical valve replacement may not be suitable in Asian populations. Thus, we aimed to identify an accurate model for predicting bleeding in elderly patients receiving warfarin after mechanical valve replacement in a Korean population. In this retrospective cohort study, a random forest model was used to determine factors predicting bleeding events among 598 participants. Twenty-two descriptors were selected as predictors for bleeding. Steroid use was the most important predictor of bleeding events, followed by labile int...
Source: Medicine - May 14, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Effectiveness and Safety of Direct Oral Anticoagulants Versus Warfarin in Patients With Valvular Atrial Fibrillation : A Population-Based Cohort Study
CONCLUSION: In this comparative effectiveness study using practice-based claims data, 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. These data may be used to guide risk-benefit discussions regarding anticoagulant choices for patients with valvular AF.PRIMARY FUNDING SOURCE: None.PMID:33780291 | DOI:10.7326/M20-6194
Source: Annals of Internal Medicine - March 29, 2021 Category: Internal Medicine Authors: Ghadeer K Dawwas Eric Dietrich Adam Cuker Geoffrey D Barnes Charles E Leonard James D Lewis Source Type: research

The risk of gastrointestinal hemorrhage with non-vitamin K antagonist oral anticoagulants: A network meta-analysis
Conclusion: Individual NOACs had varying profiles of GI bleeding risk. Results of analyses including only RCTs and those including both RCTs and population studies showed similar trends, but also showed several differences.
Source: Medicine - March 19, 2021 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Risk of Stroke and Bleeding in Atrial Fibrillation Treated with Apixaban Compared with Warfarin
ConclusionIn NVAF patients of all ages initiating either apixaban or warfarin for stroke prevention in the Sentinel System, apixaban was associated with a decreased risk of GI bleeding, ICH, and ischemic stroke compared with warfarin. Among patients less than 65  years of age, apixaban use was associated with a decreased risk of GI bleeding and ischemic stroke.
Source: Journal of General Internal Medicine - September 27, 2020 Category: Internal Medicine Source Type: research

Meta-analysis of the efficacy and safety of non-vitamin K antagonist oral anticoagulants with warfarin in Latin American patients with atrial fibrillation
Conclusions: Our meta-analysis suggested that the use of NOACs was at least non-inferior to warfarin use for stroke prevention in Latin American patients with AF.
Source: Medicine - May 1, 2020 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Comparative Safety and Effectiveness of Direct-Acting Oral Anticoagulants Versus Warfarin: a National Cohort Study of Nursing Home Residents
ConclusionsAmong US nursing home residents, the DOACs were each associated with lower mortality versus warfarin. Misaligned DOAC dosing was common in nursing homes and was associated with clinical and mortality outcomes. Overall, DOAC users had lower rates of adverse outcomes including mortality compared with warfarin users.
Source: Journal of General Internal Medicine - April 5, 2020 Category: Internal Medicine Source Type: research

Net clinical benefit analysis of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation and chronic kidney disease: Protocol for a systematic review and meta-analysis
Conclusions: This study will provide new evidence for clinical profile of NOACs on SSE, major bleeding, all-cause death, and NCB in CKD patients. PROSPERO registration number: CRD42019116940.
Source: Medicine - June 1, 2019 Category: Internal Medicine Tags: Research Article: Study Protocol Systematic Review Source Type: research

Oral Anticoagulants in Japanese Patients with Atrial Fibrillation and Active Cancer.
Conclusion The rates of stroke or systemic embolism and major bleeding events were not negligible among Japanese cancer patients with AF receiving OACs. Further investigations on the optimal management of Japanese patients with AF and cancer are needed. PMID: 30799369 [PubMed - as supplied by publisher]
Source: Internal Medicine - February 26, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Comparison of dabigatran and warfarin used in patients with non-valvular atrial fibrillation: Meta-analysis of random control trial
Conclusion: No significant difference was obtained between 110 mg dabigatran and warfarin in the incidence of stroke and embolic events. However, the 110 mg dabigatran associated lower incidence of bleeding compare with warfarin. When compared with 150 mg dabigatran, warfarin associated with lower incidence of stroke and embolic events but similar in the incidence of bleeding.
Source: Medicine - November 1, 2018 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Interventions for Preventing Thromboembolic Events in Patients With Atrial Fibrillation: A Systematic Review.
Conclusion: The available direct-acting oral anticoagulants (DOACs) are at least as effective and safe as warfarin for patients with nonvalvular AF. The DOACs had similar benefits across several patient subgroups and seemed safe and efficacious for a wide range of patients with nonvalvular AF. Primary Funding Source: Patient-Centered Outcomes Research Institute. (PROSPERO: CRD42017069999). PMID: 30383133 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - October 30, 2018 Category: Internal Medicine Authors: Lowenstern A, Al-Khatib SM, Sharan L, Chatterjee R, LaPointe NMA, Shah B, Borre ED, Raitz G, Goode A, Yapa R, Davis JK, Lallinger K, Schmidt R, Kosinski AS, Sanders GD Tags: Ann Intern Med Source Type: research

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