Does Obesity Modify Efficacy of Direct Oral Anticoagulants in Atrial Fibrillation?

The prevalence of atrial fibrillation (AF) is higher among obese patients. Yet, there is concern about possible diminished efficacy and safety of direct oral anticoagulants (DOACs) for stroke prevention in AF in this at-risk group, as well as in underweight individuals. To date, subgroup analyses from individual trials have been underpowered to provide clear inferences. The current study used pooled individual participant data from randomized trials to examine the efficacy and safety of DOACs across the spectrums of body weight and body-mass index (BMI).

Data were from ≈58,000 patients participating in four pivotal trials comparing individual DOACs (dabigatran, rivaroxaban, apixaban, and edoxaban) with vitamin K antagonists (VKAs) in AF. The…