Risk of Stroke and other Thromboembolic Complications after Interruption of DOAC Therapy Compared with Warfarin Therapy in Patients with Atrial Fibrillation: A Retrospective Cohort Analysis

• DOI: 10.1136/jim-2020-001497
• Publication Date: 2021-08-05T16:35:27Z
• Authors: Moran Hellerman I...; Noam Greenberg; Ili Margalit; Tzippy Shochat; Ilan Krause; Elad Goldberg
• Keywords: Stroke; Apixaban; Medical record

Direct oral anticoagulants (DOACs) have become the treatment of choice in thromboembolism prophylaxis for non-valvular atrial fibrillation, surpassing warfarin. While interruption DOAC therapy various reasons is a common eventuality, body data from real-world clinical practice on implications such interruptions different settings still limited. We assessed complication rates (apixaban, rivaroxaban, dabigatran) compared with warfarin hospitalized patients. performed retrospective cohort analysis electronic records patients Rabin Medical Center between 2010 and 2017. Incidents anticoagulation (including unintended interruptions) were collected. DOAC-treated excluded if they reported non-compliance, warfarin-treated their international normalized ratio measurement admission was subtherapeutic. Outcomes included ischemic stroke, systemic thromboembolism, myocardial infarction, all-cause mortality within 90 days interruption. The median CHA2DS2-VASc score 5.0 (IQR 4.0-6.0) both groups. associated risk thromboembolic complications, after not significantly 2 Selective comparison who well balanced before to did influence outcomes. This study find significant difference rate high thromboembolism.