For Valvular Atrial Fibrillation, DOACs Seem to Outperform Warfarin

By Kelly Young

Edited by David G. Fairchild, MD, MPH, and Jaye Elizabeth Hefner, MD

Direct oral anticoagulants (DOACs) are associated with better outcomes than warfarin among patients with valvular atrial fibrillation (AF), according to a retrospective study in the Annals of Internal Medicine.

Using a U.S. commercial insurance database, researchers matched roughly 28,000 new users of DOACs with new users of warfarin. During a median follow-up of roughly 130 days, the rate of stroke or systemic embolism was significantly lower among DOAC users than warfarin users (3.9 vs. 6.0 events per 100 person-years). The rate of major bleeding events was also lower among DOAC users (7.1 vs. 10.6 events per 100 person-years).

The authors conclude: "These data may be used to guide risk–benefit discussions regarding anticoagulant choices for patients with valvular AF."