Direct Oral Anticoagulants in Patients With Nonvalvular Atrial Fibrillation and Low Body Weight

Journal of the American College of Cardiology
So-Ryoung LeeGregory Y H Lip

Abstract

It is unclear whether the overall effectiveness and safety of direct oral anticoagulants (DOACs) are consistent in patients with nonvalvular atrial fibrillation (AF) and extremely low body weight (<50 kg). This study compared DOACs with warfarin in AF patients with low body weight. Using data from the Korean National Health Insurance Service database from January 2014 to December 2016, AF patients with body weight ≤60 kg and who were treated with oral anticoagulants (n = 14,013 taking DOACs and n = 7,576 taking warfarin) were included and examined for ischemic stroke, intracranial hemorrhage (ICH), gastrointestinal bleeding, major bleeding, all-cause death, and composite outcome. The propensity score weighting was used to balance the 2 groups. Baseline characteristics were well balanced between the 2 groups (mean age 73 years, mean CHA2DS2-VASc score 4, and 28% of patients weighed <50 kg). DOACs were associated with lower risks of ischemic stroke (hazard ratio [HR]: 0.591; 95% confidence interval [CI]: 0.510 to 0.686) and major bleeding (HR: 0.705; 95%: CI 0.601 to 0.825), which were caused by a reduction in ICH (HR: 0.554; 95% CI: 0.429 to 0.713) compared with warfarin. DOAC improved the net clinical benefit compared with warf...Continue Reading

Citations

Jan 28, 2020·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Aaqib H MalikUNKNOWN MAGIC (Meta-analysis And oriGinal Investigations in Cardiology) Investigators
Mar 13, 2020·Circulation. Cardiovascular Quality and Outcomes·So-Ryoung LeeGregory Y H Lip
Apr 16, 2020·JAMA Network Open·Ken OkumuraUNKNOWN J-RISK AF Research Group
Jul 23, 2020·European Journal of Clinical Investigation·Vincenzo RussoGerardo Nigro
Jul 30, 2020·Korean Circulation Journal·Eue Keun Choi
Aug 28, 2020·Journal of Clinical Medicine·Rungroj KrittayaphongGregory Y H Lip
Jun 17, 2020·Journal of the American Heart Association·Ashley ChenBruce A Warden
Jul 30, 2020·Korean Circulation Journal·Haechan ChoKyung Woo Park
Jul 26, 2019·American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions·Yue ZhouWengen Zhu
Oct 22, 2020·Thrombosis and Haemostasis·So-Ryoung Lee, Eue-Keun Choi
Jan 12, 2021·Stroke; a Journal of Cerebral Circulation·So-Ryoung LeeGregory Y H Lip
Jan 21, 2021·European Heart Journal. Cardiovascular Pharmacotherapy·So-Ryoung LeeGregory Y H Lip
Mar 26, 2021·Circulation Journal : Official Journal of the Japanese Circulation Society·Ken OkumuraUNKNOWN J-RISK AF Research Group
Apr 26, 2020·Cardiology in Review·Filipe FerrariRicardo Stein
Apr 26, 2021·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Jan SteffelUNKNOWN External reviewers
Jun 3, 2021·Journal of Clinical Medicine·So-Ryoung LeeGregory Y H Lip
Jul 4, 2021·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Soonil KwonGregory Y H Lip
Jul 27, 2021·European Journal of Clinical Investigation·Francesca BodegaUNKNOWN INSigHT (Italian DOACs San Raffaele Hospital) registry investigators

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