Safety and efficacy of non-vitamin K antagonist oral anticoagulants compared with well-controlled warfarin in Thai patients with atrial fibrillation.

IF 0.4 4区 医学 Q4 MEDICINE, RESEARCH & EXPERIMENTAL
Janekij Yamkasikorn, Komsing Methavigul
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引用次数: 0

Abstract

Background: In trials of patients with atrial fibrillation (AF), non-vitamin K antagonist oral anticoagulants (NOACs) were not inferior to warfarin for thromboembolic and bleeding events. However, there are scant data comparing the efficacy and safety of NOACs in patients with AF with that of well-controlled warfarin treatment in such patients.

Objectives: To compare total bleeding and thromboembolic events in patients with AF who received NOACs, with the same events in those who received well-controlled warfarin treatment.

Methods: We used retrospective data from patients with AF who received NOACs or well-controlled warfarin at the Central Chest Institute of Thailand from January 2017 to December 2019. The primary outcome was total bleeding or thromboembolic events or both. The secondary outcome was all-cause mortality, total bleeding events including major or minor bleeding, and thromboembolic events including ischemic stroke or systemic embolization.

Results: We included data from 180 patients with AF, 90 who received NOACs and 90 who received well-controlled warfarin. The average time in the therapeutic range for those who received warfarin was 84.9% ± 9.8%. The patients who received well-controlled warfarin had more frequent thromboembolic or total bleeding events or both than those who received NOACs (odds ratio [OR] 3.17; 95% confidence interval [CI] 2.27-4.07; P = 0.01). There were more minor bleeding events in those who received well-controlled warfarin (OR 3.75; 95% CI 2.79-4.71; P = 0.01). However, there was no significant difference in thromboembolic events, major bleeding, or all-cause mortality between the 2 groups.

Conclusions: Thai patients with AF who received NOACs had less thromboembolic or total bleeding events than those who received well-controlled warfarin treatment.

Abstract Image

非维生素K拮抗剂口服抗凝剂与控制良好的华法林在泰国房颤患者中的安全性和有效性比较
背景:在心房颤动(AF)患者的试验中,非维生素K拮抗剂口服抗凝剂(NOACs)在血栓栓塞和出血事件方面并不逊色于华法林。然而,比较NOACs在房颤患者中的疗效和安全性与控制良好的华法林治疗在此类患者中的疗效和安全性的数据很少。目的:比较接受NOACs治疗的AF患者的总出血和血栓栓塞事件与接受良好控制的华法林治疗的AF患者的总出血和血栓栓塞事件。方法:我们使用了2017年1月至2019年12月在泰国中央胸科研究所接受noac或控制良好的华法林治疗的房颤患者的回顾性数据。主要结局是总出血或血栓栓塞事件或两者兼而有之。次要结局是全因死亡率、总出血事件(包括大出血或小出血)和血栓栓塞事件(包括缺血性卒中或全身栓塞)。结果:我们纳入了180例房颤患者的数据,其中90例接受noac治疗,90例接受控制良好的华法林治疗。华法林组在治疗范围内的平均时间为84.9%±9.8%。接受控制良好的华法林治疗的患者血栓栓塞或总出血事件发生率高于接受NOACs治疗的患者(优势比[or] 3.17;95%置信区间[CI] 2.27-4.07;P = 0.01)。接受控制良好的华法林治疗的患者有更多的轻微出血事件(OR 3.75;95% ci 2.79-4.71;P = 0.01)。然而,两组在血栓栓塞事件、大出血或全因死亡率方面没有显著差异。结论:接受NOACs治疗的泰国房颤患者血栓栓塞或总出血事件少于接受控制良好的华法林治疗的患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Asian Biomedicine
Asian Biomedicine 医学-医学:研究与实验
CiteScore
1.20
自引率
0.00%
发文量
24
审稿时长
6-12 weeks
期刊介绍: Asian Biomedicine: Research, Reviews and News (ISSN 1905-7415 print; 1875-855X online) is published in one volume (of 6 bimonthly issues) a year since 2007. [...]Asian Biomedicine is an international, general medical and biomedical journal that aims to publish original peer-reviewed contributions dealing with various topics in the biomedical and health sciences from basic experimental to clinical aspects. The work and authorship must be strongly affiliated with a country in Asia, or with specific importance and relevance to the Asian region. The Journal will publish reviews, original experimental studies, observational studies, technical and clinical (case) reports, practice guidelines, historical perspectives of Asian biomedicine, clinicopathological conferences, and commentaries Asian biomedicine is intended for a broad and international audience, primarily those in the health professions including researchers, physician practitioners, basic medical scientists, dentists, educators, administrators, those in the assistive professions, such as nurses, and the many types of allied health professionals in research and health care delivery systems including those in training.
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