Thursday, September 1, 2016

Stroke Prevention for Patients With Atrial Fibrillation Similar With Warfarin, Newer Oral Anticoagulants

Didn't answer the outstanding question that there is no reversal agent for the newer ones. How many died or had negative outcomes because of no reversal agent? Can't these people even think of the correct questions to answer while doing research? Must I do everything? Think and wipe their ass?
http://dgnews.docguide.com/stroke-prevention-patients-atrial-fibrillation-similar-warfarin-newer-oral-anticoagulants?
An observational study comparing new oral anticoagulants with warfarin found stroke prevention to be similar, but the newer anticoagulants provided reduced intracranial bleeding, according to a study presented here at the 2016 Annual Meeting of the European Society of Cardiology (ESC).
The study included 43,299 patients with atrial fibrillation who were recruited from Danish nationwide administrative registries. In the cohort, 42% of patients were taking warfarin, 29% were taking dabigatran, 16% were on apixaban, and 13% were taking rivaroxaban.
“There has been a need to investigate safety and effectiveness of new oral anticoagulants versus warfarin in a ‘real world’ population and our Danish registries provide this opportunity,” said Laila Staerk, MD, Herlev and Gentofte University Hospitals, Herlev, Denmark.
Efficacy outcomes were stroke and all-cause mortality. Patients were followed until outcome, death, switch or discontinuation of initiated anticoagulant treatment, emigration, or study end.
During treatment, stroke occurred in 1,850 (4%) patients and there were 6,477 (15%) deaths.
The absolute stroke risk at 1 year of initiating treatment was similar for each of the 4 groups, at 2.01% for warfarin, 2.12% for dabigatran, 2.06% for rivaroxaban, and 2.46% for apixaban.
Absolute risk of all-cause mortality at 1 year after initiation of warfarin was 18.0%, dabigatran 11.5%, rivaroxaban 14.7%, and apixaban 14.9%.
Standardised absolute risk of intracranial bleeding at 1 year was reduced in patients who were taking the newer oral anticoagulants. Absolute risk was 0.60% for warfarin, 0.26% for dabigatran (P =0.05 vs warfarin), 0.47% for rivaroxaban, and 0.40% for apixaban (P = .05 vs warfarin).
“Among patients with atrial fibrillation who were new users of oral anticoagulation, while treatment with [these newer drugs] was not associated with a significantly lower risk of stroke, treatment with dabigatran and apixaban was associated with a significantly lower risk of intracranial bleeding compared with warfarin,” said Dr. Staerk.
[Presentation title: Stroke and All-Cause Mortality With Non-Vitamin K Antagonist Oral Anticoagulation Versus Warfarin in Atrial Fibrillation: a Nationwide Study. Abstract 1875]

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