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Effectiveness and Safety of Oral Anticoagulants among NVAF Patients with Obesity: Insights from the ARISTOPHANES Study

This ARISTOPHANES analysis examined stroke/systemic embolism (SE) and major bleeding (MB) among a subgroup of nonvalvular atrial fibrillation (NVAF) patients with obesity prescribed warfarin or non-vitamin K antagonist oral anticoagulants (NOACs) in order to inform clinical decision making. A retros...

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Autores principales: Deitelzweig, Steve, Keshishian, Allison, Kang, Amiee, Dhamane, Amol D., Luo, Xuemei, Li, Xiaoyan, Balachander, Neeraja, Rosenblatt, Lisa, Mardekian, Jack, Pan, Xianying, Di Fusco, Manuela, Garcia Reeves, Alessandra B., Yuce, Huseyin, Lip, Gregory Y. H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7355744/
https://www.ncbi.nlm.nih.gov/pubmed/32481607
http://dx.doi.org/10.3390/jcm9061633
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author Deitelzweig, Steve
Keshishian, Allison
Kang, Amiee
Dhamane, Amol D.
Luo, Xuemei
Li, Xiaoyan
Balachander, Neeraja
Rosenblatt, Lisa
Mardekian, Jack
Pan, Xianying
Di Fusco, Manuela
Garcia Reeves, Alessandra B.
Yuce, Huseyin
Lip, Gregory Y. H.
author_facet Deitelzweig, Steve
Keshishian, Allison
Kang, Amiee
Dhamane, Amol D.
Luo, Xuemei
Li, Xiaoyan
Balachander, Neeraja
Rosenblatt, Lisa
Mardekian, Jack
Pan, Xianying
Di Fusco, Manuela
Garcia Reeves, Alessandra B.
Yuce, Huseyin
Lip, Gregory Y. H.
author_sort Deitelzweig, Steve
collection PubMed
description This ARISTOPHANES analysis examined stroke/systemic embolism (SE) and major bleeding (MB) among a subgroup of nonvalvular atrial fibrillation (NVAF) patients with obesity prescribed warfarin or non-vitamin K antagonist oral anticoagulants (NOACs) in order to inform clinical decision making. A retrospective observational study was conducted among NVAF patients who were obese and initiated apixaban, dabigatran, rivaroxaban, or warfarin from 1 January 2013–30 September 2015, with data pooled from CMS Medicare and four US commercial claims databases. Propensity score matching was completed between NOACs and against warfarin in each database, and the results were pooled. Cox models were used to evaluate the risks of stroke/SE and MB. A total of 88,461 patients with obesity were included in the study. Apixaban and rivaroxaban were associated with a lower risk of stroke/SE vs. warfarin (HR: 0.63, 95% CI: 0.49–0.82 and HR: 0.84, 95% CI: 0.72–0.98). Dabigatran was associated with a similar risk of stroke/SE compared to warfarin. Compared with warfarin, apixaban and dabigatran had a lower risk of MB (HR: 0.54, 95% CI: 0.49–0.61 and HR: 0.75, 95% CI: 0.63–0.91). Rivaroxaban was associated with a similar risk of MB compared to warfarin. In this high-risk population with obesity, NOACs had a varying risk of stroke/SE and MB vs. warfarin.
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spelling pubmed-73557442020-07-23 Effectiveness and Safety of Oral Anticoagulants among NVAF Patients with Obesity: Insights from the ARISTOPHANES Study Deitelzweig, Steve Keshishian, Allison Kang, Amiee Dhamane, Amol D. Luo, Xuemei Li, Xiaoyan Balachander, Neeraja Rosenblatt, Lisa Mardekian, Jack Pan, Xianying Di Fusco, Manuela Garcia Reeves, Alessandra B. Yuce, Huseyin Lip, Gregory Y. H. J Clin Med Article This ARISTOPHANES analysis examined stroke/systemic embolism (SE) and major bleeding (MB) among a subgroup of nonvalvular atrial fibrillation (NVAF) patients with obesity prescribed warfarin or non-vitamin K antagonist oral anticoagulants (NOACs) in order to inform clinical decision making. A retrospective observational study was conducted among NVAF patients who were obese and initiated apixaban, dabigatran, rivaroxaban, or warfarin from 1 January 2013–30 September 2015, with data pooled from CMS Medicare and four US commercial claims databases. Propensity score matching was completed between NOACs and against warfarin in each database, and the results were pooled. Cox models were used to evaluate the risks of stroke/SE and MB. A total of 88,461 patients with obesity were included in the study. Apixaban and rivaroxaban were associated with a lower risk of stroke/SE vs. warfarin (HR: 0.63, 95% CI: 0.49–0.82 and HR: 0.84, 95% CI: 0.72–0.98). Dabigatran was associated with a similar risk of stroke/SE compared to warfarin. Compared with warfarin, apixaban and dabigatran had a lower risk of MB (HR: 0.54, 95% CI: 0.49–0.61 and HR: 0.75, 95% CI: 0.63–0.91). Rivaroxaban was associated with a similar risk of MB compared to warfarin. In this high-risk population with obesity, NOACs had a varying risk of stroke/SE and MB vs. warfarin. MDPI 2020-05-28 /pmc/articles/PMC7355744/ /pubmed/32481607 http://dx.doi.org/10.3390/jcm9061633 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Deitelzweig, Steve
Keshishian, Allison
Kang, Amiee
Dhamane, Amol D.
Luo, Xuemei
Li, Xiaoyan
Balachander, Neeraja
Rosenblatt, Lisa
Mardekian, Jack
Pan, Xianying
Di Fusco, Manuela
Garcia Reeves, Alessandra B.
Yuce, Huseyin
Lip, Gregory Y. H.
Effectiveness and Safety of Oral Anticoagulants among NVAF Patients with Obesity: Insights from the ARISTOPHANES Study
title Effectiveness and Safety of Oral Anticoagulants among NVAF Patients with Obesity: Insights from the ARISTOPHANES Study
title_full Effectiveness and Safety of Oral Anticoagulants among NVAF Patients with Obesity: Insights from the ARISTOPHANES Study
title_fullStr Effectiveness and Safety of Oral Anticoagulants among NVAF Patients with Obesity: Insights from the ARISTOPHANES Study
title_full_unstemmed Effectiveness and Safety of Oral Anticoagulants among NVAF Patients with Obesity: Insights from the ARISTOPHANES Study
title_short Effectiveness and Safety of Oral Anticoagulants among NVAF Patients with Obesity: Insights from the ARISTOPHANES Study
title_sort effectiveness and safety of oral anticoagulants among nvaf patients with obesity: insights from the aristophanes study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7355744/
https://www.ncbi.nlm.nih.gov/pubmed/32481607
http://dx.doi.org/10.3390/jcm9061633
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