Comparison of NOACs with Warfarin In Atrial Fibrillation Patients With Single Stroke Risk Factor

MedicalResearch.com Interview with:

Gregory Y. H. Lip, MD Professor of Cardiovascular Medicine University of Birmingham, UK; Adjunct Professor of Cardiovascular Sciences, Thrombosis Research Unit, Aalborg University, Denmark National Institute for Health Research (NIHR) Senior Investigator. Visiting Professor of Haemostasis Thrombosis & Vascular Sciences, Aston University, Birmingham, UK Visiting Professor of Cardiology, University of Belgrade, Serbia; Visiting Professor, University of Leeds, UK Honorary Professor, Chinese PLA Medical School, Beijing, China; Honorary Professor, Nanjing Medical University, Nanjing, China; Visiting Professor, National Yang-Ming University, Taipei, Taiwan Institute of Cardiovascular Sciences City Hospital Birmingham England UK

Dr. Lip

Gregory Y. H. Lip, MD
Professor of Cardiovascular Medicine
University of Birmingham
Adjunct Professor of Cardiovascular Sciences, Thrombosis Research Unit, Aalborg University, Denmark
National Institute for Health Research (NIHR) Senior Investigator.
Visiting Professor of Haemostasis Thrombosis & Vascular Sciences, Aston University, Birmingham, UK
Institute of Cardiovascular Sciences
City Hospital
Birmingham England UK

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The randomized clinical trials comparing non-Vitamin K antagonist oral anticoagulants (NOACs) vs warfarin largely focused on recruitment of high risk atrial fibrillation(AF) patients with >2 stroke risk factors, with only the trials testing dabigatran or apixaban including a minority of patients with 1 stroke risk factor.

Despite this, regulatory approvals of all NOACs have been for stroke prevention in AF patients with ≥1 stroke risk factors. No difference between NOACs compared to warfarin in risk of ischemic stroke/systemic embolism, was seen but for ‘any bleeding’, this was lower for apixaban and dabigatran compared to warfarin.

MedicalResearch.com: What should readers take away from your report?

Response: Our data show no significant differences of the NOACs compared to warfarin for ischemic stroke/systemic embolism, but for ‘any bleeding’, this was lower for apixaban and dabigatran. In patients with a single non-gender stroke risk factor, the NOACs would be appropriate thromboprophylaxis given the comparative effectiveness and safety compared to warfarin

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: Our data do not allow for a definitive statement of comparative effectiveness or safety of NOACs due to possible residual confounding, thus further prospective studies would be

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Lip GYH, Skjøth F, Nielsen PB, Kjældgaard JN, Larsen TB. Effectiveness and Safety of Standard-Dose Nonvitamin K Antagonist Oral Anticoagulants and Warfarin Among Patients With Atrial Fibrillation With a Single Stroke Risk FactorA Nationwide Cohort Study. JAMA Cardiol. Published online June 14, 2017. doi:10.1001/jamacardio.2017.1883

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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