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The Article in Brief
Anticoagulants' Safety and Effectiveness in General Practice: A Nationwide Prospective Cohort Study
Paul Frappe , and colleagues
Background Oral anticoagulant medications, like warfarin--a vitamin K antagonist, have well-proven effectiveness for those atrial fibrillation and venous thromboembolic disease indications but the drugs are associated with increased bleeding risk. The aim of this study was to compare safety and effectiveness between patients treated with vitamin K antagonists (VKAs) and patients treated with direct oral anticoagulants (DOACs) in a general practice setting.
What This Study Found Researchers tracked 1,882 adult primary care patients treated with either VKA or DOAC in their usual primary care. Their doctors recorded incidences of significant bleeding events, blood clots and death over the course of one year. Researchers then compared health outcomes for the two drug groups using a matched propensity score model. The two groups had similar rates of serious adverse events, like blood clots and major bleeding, however the VKA group had a lower incidence of minor and non-major clinically significant bleeding. However, the study also showed two times higher incidence of death in the VKA group.
Implications
- The two times higher incidence of death among patients taking VKAs aligns with prior analysis from health insurance data. The authors call for further research to explain the excess mortality with VKA.