Safety and efficacy of non–vitamin K antagonist oral anticoagulants compared with well-controlled warfarin in Thai patients with atrial fibrillation
and | Jun 30, 2022
Article Category: Brief communication (original)
Published Online: Jun 30, 2022
Page range: 131 - 136
DOI: https://doi.org/10.2478/abm-2022-0016
Keywords
© 2022 Janekij Yamkasikorn et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.
Background
In trials of patients with atrial fibrillation (AF), non–vitamin K antagonist oral anticoagulants (NOACs) were not inferior to warfarin for thromboembolic and bleeding events. However, there are scant data comparing the efficacy and safety of NOACs in patients with AF with that of well-controlled warfarin treatment in such patients.
Objectives
To compare total bleeding and thromboembolic events in patients with AF who received NOACs, with the same events in those who received well-controlled warfarin treatment.
Methods
We used retrospective data from patients with AF who received NOACs or well-controlled warfarin at the Central Chest Institute of Thailand from January 2017 to December 2019. The primary outcome was total bleeding or thromboembolic events or both. The secondary outcome was all-cause mortality, total bleeding events including major or minor bleeding, and thromboembolic events including ischemic stroke or systemic embolization.
Results
We included data from 180 patients with AF, 90 who received NOACs and 90 who received well-controlled warfarin. The average time in the therapeutic range for those who received warfarin was 84.9% ± 9.8%. The patients who received well-controlled warfarin had more frequent thromboembolic or total bleeding events or both than those who received NOACs (odds ratio [OR] 3.17; 95% confidence interval [CI] 2.27–4.07;
Conclusions
Thai patients with AF who received NOACs had less thromboembolic or total bleeding events than those who received well-controlled warfarin treatment.