Long-term stroke and major bleeding risk in patients with non-valvular atrial fibrillation: A comparative analysis between non-vitamin K antagonist oral anticoagulants and warfarin using a clinical data warehouse

• DOI: 10.3389/fneur.2023.1058781
• Publication Date: 2023-01-26T06:12:08Z
• Authors: Hancheol Lee; Jung Hwa Hong; Kwon-Duk Seo
• Keywords: Vitamin K antagonist; Stroke; Gastrointestinal bleeding

Non-vitamin K antagonist oral anticoagulants (NOACs) has been the drug of choice for preventing ischemic stroke in patients with atrial fibrillation (AF) since 2014. Many studies based on claim data revealed that NOACs had comparable effect to warfarin fewer hemorrhagic side effects. We analyzed difference clinical outcomes according drugs AF warehouse (CDW).We extracted from our hospital's CDW and obtained information including test results. All were National Health Insurance Service, dataset was constructed by combining it data. Separately, another who could obtain sufficient CDW. The divided NOAC groups. occurrence stroke, intracranial hemorrhage, gastrointestinal bleeding, death confirmed as outcome. factors influencing risk analyzed.The diagnosed between 2009 2020 included construction. In combined dataset, 858 treated warfarin, 2,343 NOACs. After diagnosis AF, incidence during follow-up 199 (23.2%) group, 209 (8.9%) group. Intracranial hemorrhage occurred 70 (8.2%) among 61 (2.6%) Gastrointestinal bleeding 69 (8.0%) 78 (3.3%) NOAC's hazard ratio (HR) 0.479 (95% CI 0.39-0.589, p < 0.0001), HR 0.453 0.31-0.664, 0.579 0.406-0.824, = 0.0024). using only CDW, group also a lower than group.In this study, are more effective safer even long-term follow-up. should be used prevent AF.