Superior safety of direct oral anticoagulants compared to Warfarin in patients with atrial fibrillation and underlying cancer: a national veterans affairs database study
Abhishek C Sawant
Arnav Kumar
Wilmon Mccray
Sheldon Tetewsky
Linda Parone
Srilekha Sridhara
Meghana Prakash Hiriyur Prakash
Gary Tse
Tong LIU
Nidhi Kanwar
Aishwarya Bhardwaj
Sahoor Khan
Christopher Manion
Ankush Lahoti
Ashish Pershad
Peter Elkin
John Corbelli
摘要：Background Studies evaluating safety of warfarin and direct oral anticoagulants (DOACs) for prevention of stroke in patients with atrial fibrillation (AF) are lacking.Methods & Results All patients (n =196,521) receiving care at veteran's affairs with active cancer and AF from 2010-2015 were included.One-year mortality was significantly higher in unadjusted analysis with warfarin (44.9％) compared to dabigatran (25％,P ＜ 0.001),rivaroxaban (24.4％,P ＜ 0.001) and apixaban (30％,P ＜ 0.001) and after adjusting for age,sex and type of cancer mortality (OR =2.66,95％ CI:2.52-2.82,P ＜ 0.001).Risk of ischemic stroke (13.5％ vs.11.1％,12.0％,14.0％) was similar,however risk of hemorrhagic stroke was significantly higher among patients receiving warfarin (1.2％) compared to patients receiving dabigatran (0.5％),rivaroxaban (0.7％) and apixaban (0.8％) respectively,P =0.04.Conclusions We demonstrated the superior safety profile of DOACs compared to warfarin among patients with underlying cancer and AF.Warfarin was associated with higher mortality,similar ischemic stroke risk but higher risk of hemorrhagic stroke.
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论文发表日期：2019-01-01
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：4( 706-709 )
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