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Randomized trials have demonstrated equivalence or superiority in safety and effectiveness of direct-acting oral anticoagulants (DOACs) compared with warfarin in patients with nonvalvular atrial fibrillation (AF). However, these trials did not include nursing home residents. In this cohort study, researchers compared DOACs and warfarin in several thousand U.S. nursing home residents (median age, 84) with nonvalvular AF.
New users of DOACs were propensity-matched with new users of warfarin. After about 5 months of follow-up, the following outcomes were noted:
Apixaban users had statistically borderline higher risk for ischemic stroke (hazard ratio, 1.9) but significantly lower risks for bleeding (HR, 0.7) and death (HR, 0.8) than did warfarin …