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dc.contributor.authorHalvorsen, Sigrun
dc.contributor.authorJohnsen, Søren P.
dc.contributor.authorMadsen, Morten
dc.contributor.authorLinder, Marie
dc.contributor.authorSulo, Gerhard
dc.contributor.authorGhanima, Waleed
dc.contributor.authorGislason, Gunnar
dc.contributor.authorHohnloser, Stefan H.
dc.contributor.authorJenkins, Aaron
dc.contributor.authorAl-Khalili, Faris
dc.contributor.authorTell, Grethe S.
dc.contributor.authorEhrenstein, Vera
dc.description.abstractAims Using Scandinavian population-based registries, we assessed risk of stroke/systemic embolism (SE) and bleeding with non-vitamin K antagonist oral anticoagulants compared with warfarin in anticoagulation-naïve patients with atrial fibrillation (AF). Methods and results This historical cohort study included 219 545 AF patients [median age 74 years; 43% women; mean CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke or transient ischaemic attack, vascular disease, age 65–74 years, sex category) score 3.3] initiating apixaban, dabigatran, rivaroxaban, or warfarin in Denmark, Norway, and Sweden (1 January 2013 to 31 December 2016). The primary endpoints were stroke/SE and major bleeding. The median follow-up times were 9.7 (3.9–21.5) months for stroke/SE and 9.6 (3.8–21.3) months for bleeding. Apixaban and warfarin initiators were older and had higher CHA2DS2-VASc scores compared with dabigatran and rivaroxaban initiators. After 1:1 propensity score matching, three cohorts were created: apixaban–warfarin (n = 111 162), dabigatran–warfarin (n = 56 856), and rivaroxaban–warfarin (n = 61 198). Adjusted hazard ratios (HRs) were estimated using a Cox regression. For stroke/SE, adjusted HRs against warfarin were 0.96 [95% confidence interval (CI): 0.87–1.06] for apixaban, 0.89 (95% CI: 0.80–1.00) for dabigatran, and 1.03 (95% CI: 0.92–1.14) for rivaroxaban. For major bleeding, the HRs against warfarin were 0.73 (95% CI: 0.67–0.78) for apixaban, 0.89 (95% CI: 0.82–0.97) for dabigatran, and 1.15 (95% CI: 1.07–1.25) for rivaroxaban. The results in the dabigatran cohort did not hold in all dose-defined subgroups. Conclusion In this large Scandinavian study among AF patients initiating oral anticoagulation, those initiating dabigatran, apixaban, and rivaroxaban had similar rates of stroke/SE to patients initiating warfarin. Rates of major bleeding were lower with apixaban and dabigatran and higher with rivaroxaban, each compared with warfarin.en_US
dc.publisherOxford University Pressen_US
dc.rightsNavngivelse-Ikkekommersiell 4.0 Internasjonal*
dc.titleEffectiveness and safety of non-vitamin K antagonist oral anticoagulants and warfarin in atrial fibrillation: a scandinavian population-based cohort studyen_US
dc.typeJournal articleen_US
dc.typePeer revieweden_US
dc.rights.holder© The Author(s) 2021.en_US
dc.source.journalEuropean Heart Journal - Quality of Care and Clinical Outcomesen_US
dc.identifier.citationEuropean Heart Journal - Quality of Care and Clinical Outcomes. 2021, qcab048.en_US

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Navngivelse-Ikkekommersiell 4.0 Internasjonal
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