scholarly journals Choosing between continuing vitamin K antagonists (VKA) or switching to a direct oral anticoagulant in currently well-controlled patients on VKA for atrial fibrillation: a randomised controlled trial (GAInN)

2019 ◽  
Vol 186 (3) ◽  
pp. e21-e23 ◽  
Author(s):  
Jasper H. A. van Miert ◽  
Hilde A. M. Kooistra ◽  
Nic J. G. M. Veeger ◽  
Annelies Westerterp ◽  
Margriet Piersma-Wichers ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Randomised Controlled Trial ◽  
Vitamin K ◽  
Oral Anticoagulant ◽  
Controlled Trial ◽  
Vitamin K Antagonists ◽  
Direct Oral Anticoagulant ◽  
Randomised Controlled

scholarly journals Az edoxabán véralvadásgátló hatásossága és biztonságossága nonvalvuláris pitvarfibrillációban

2018 ◽  
Vol 159 (12) ◽  
pp. 466-469
Author(s):  
Andrea Szegedi ◽  
Zoltán Csanádi
Keyword(s):  
Atrial Fibrillation ◽  
Anticoagulant Therapy ◽  
Vitamin K ◽  
Oral Anticoagulant ◽  
Randomized Trials ◽  
Vitamin K Antagonists ◽  
Thromboembolic Events ◽  
Direct Oral Anticoagulant ◽  
Anticoagulant Drugs

Abstract: The significantly increased incidence of stroke and systemic embolisation caused by atrial fibrillation can be prevented by adequately adjusted anticoagulant therapy. Vitamin K antagonists effectively decrease the risk of thromboembolic events but this effect is influenced by many factors. The development of the new direct oral anticoagulant drugs (DOAC) in the last few years provided new opportunities for us to choose the suitable anticoagulant therapy. According to the results of the ENGAGE AF–TIMI 48 and ENSURE-AF multicenter, randomized trials, edoxaban, the recently introduced DOAC is equally effective as the traditional coumarin therapy, nevertheless, it ensures more tolerable anticoagulation for patients suffering from non-valvular atrial fibrillation. Orv Hetil. 2018; 159(12): 466–469.

Stroke Prevention by Anticoagulants in Daily Practice Depending on Atrial Fibrillation Pattern and Clinical Risk Factors

Stroke ◽  
2021 ◽  
Author(s):  
Lamiae Grimaldi-Bensouda ◽  
Jean-Yves Le Heuzey ◽  
Jean Ferrières ◽  
Didier Leys ◽  
Jean-Marc Davy ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Vitamin K ◽  
Oral Anticoagulant ◽  
Hemorrhagic Stroke ◽  
Vitamin K Antagonists ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Clinical Risk Factors ◽  
Direct Oral Anticoagulant

Background and Purpose: The objective of the study was to assess the effectiveness of individual direct oral anticoagulants versus vitamin K antagonists for primary prevention of stroke (ischemic and hemorrhagic) in routine clinical practice in patients with various clinical risk factors depending on their atrial fibrillation (AF) patterns. Methods: A nested case-referent study was conducted using data from 2 national registries of patients with stroke and AF. Stroke cases with previous history of AF were matched to up to 2 randomly selected referent patients with AF and no stroke. The association of individual anticoagulant use with ischemic or hemorrhagic stroke was studied in patients with or without permanent AF using multivariable conditional logistic models, controlled for clinically significant risk factors and multiple other cardiovascular risk factors. Results: In total, 2586 stroke cases with previous AF and 4810 nonstroke referent patients with AF were retained for the study. Direct oral anticoagulant users had lower odds of stroke of any type than vitamin K antagonist users: the adjusted-matched OR for ischemic stroke were 0.70 (95% CI, 0.50–0.98) for dabigatran, 0.68 (95% CI, 0.53–0.86) for rivaroxaban, and 0.73 (95% CI, 0.52–1.02) for apixaban while for hemorrhagic stroke they were 0.31 (95% CI, 0.14–0.68), 0.64 (95% CI, 0.39–1.06), and 0.70 (95% CI, 0.33–1.49), respectively. The effects of individual direct oral anticoagulants relative to vitamin K antagonists were similar in permanent AF and nonpermanent AF patients. Conclusions: Similar results were observed for each direct oral anticoagulant in real life as those observed in the pivotal clinical trials. The pattern of AF did not affect the outcome.

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