Comparing Mortality Risks of Warfarin and Direct Oral Anticoagulants
Author Information
Author(s): Wang Zixuan, Matthewman Julian, Tazare John, Yu Qiuyan, Cheung Ka Shing, Chui Celine S. L., Chan Esther W. Y., Bhaskaran Krishnan, Smeeth Liam, Wong Ian C. K., Douglas Ian J., Wong Angel Y. S.
Primary Institution: London School of Hygiene and Tropical Medicine
Hypothesis
Is there a difference in mortality risk between warfarin and direct oral anticoagulants (DOACs) in patients with non-valvular atrial fibrillation?
Conclusion
The risk of all-cause mortality associated with warfarin compared to DOACs may depend on the level of anticoagulation control.
Supporting Evidence
- Warfarin users had a lower hazard of all-cause mortality in CPRD.
- Warfarin users with TTR ≥ 65% had a significantly lower hazard of mortality compared to DOAC users.
- An increased hazard of mortality was observed in warfarin users with TTR < 65%.
Takeaway
This study looked at how different blood thinners affect the risk of dying. It found that how well patients manage their blood thinner can change the risk.
Methodology
Cohort studies using UK Clinical Practice Research Datalink and Hong Kong Clinical Data Analysis and Reporting System to compare mortality risks.
Potential Biases
Potential for unmeasured confounding due to differences in patient characteristics and adherence to treatment.
Limitations
The study cannot establish a causal relationship due to the observational nature and potential confounding factors.
Participant Demographics
Participants were adults aged 18 and older with non-valvular atrial fibrillation, with a mix of demographics from England and Hong Kong.
Statistical Information
P-Value
0.81 (CPRD), 1.31 (CDARS)
Confidence Interval
0.77–0.86 (CPRD), 1.24–1.39 (CDARS)
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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