Is There a Preferred Stroke Prevention Strategy for Diabetic Patients with Non-Valvular Atrial Fibrillation? Comparing Warfarin, Dabigatran and Rivaroxaban

Thrombosis and Haemostasis
Chih-Cheng HsuHao-Min Cheng

Abstract

The prevalence of diabetes is growing, and diabetes is an independent risk factor for both atrial fibrillation (AF) and stroke. However, the relative effectiveness and safety of different oral anticoagulants for diabetic patients with non-valvular AF remain unclear. We aimed to compare thromboembolic events, bleeding and mortality in diabetic AF patients treated with rivaroxaban, dabigatran and warfarin. Diabetic AF patients taking dabigatran (n = 322), rivaroxaban (n = 320) or warfarin (n = 1,899) were identified from the nationwide diabetes pay-for-performance program (n = 814,465) in Taiwan. Outcomes and comorbidities were evaluated by linking with Taiwan National Health Insurance Research Database. Propensity score weighting method was used to balance covariates across study groups. Patients were followed up until the first occurrence of any study outcome or the study end date. Compared with warfarin, dabigatran significantly decreased the risk of all-cause mortality (hazard ratio [HR] = 0.348, 95% confidence interval [CI] = 0.157-0.771) and gastrointestinal bleeding (HR = 0.558, 95% CI = 0.327-0.955). Relative effectiveness and safety outcomes between rivaroxaban and warfarin were comparable. Compared with rivaroxaban, dab...Continue Reading

Citations

Aug 24, 2019·Frontiers in Medicine·Zafraan ZatharGregory Y H Lip
Dec 31, 2019·Journal of Diabetes Research·Dana PrídavkováMarián Mokáň
Jun 10, 2020·American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions·Yang HuaXiang-Qing Kong
Oct 31, 2020·Thrombosis and Haemostasis·Elena Ivany, Deirdre A Lane
Feb 4, 2021·Endocrinology, Diabetes & Metabolism·Yutaka SeinoUNKNOWN EMPRISE East Asia study group
Feb 2, 2021·European Journal of Internal Medicine·Giuseppe BorianiGregory Yh Lip
Aug 12, 2021·The Egyptian Heart Journal : (EHJ) : Official Bulletin of the Egyptian Society of Cardiology·Yoga WaranugrahaKhadijah Cahya Yunita
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