NOACs Superior to Warfarin for Stroke Prevention

Non-vitamin K antagonist oral anticoagulants (NOACs) were associated with a reduced risk for stroke and thromboembolism (TE) and reduced risk of bleeding compared with warfarin among patients with atrial fibrillation (AF), according to a recent study.

In their systematic review, the researchers identified 10 studies that compared the efficacy and safety of warfarin use to non-warfarin use and 16 studies that compared warfarin use with NOAC use among adults over 65 years of age with AF.
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Warfarin use was superior to aspirin and no antithrombotic therapy for the prevention of stroke and TE, but was associated with a non-significant increase risk for major bleeding.

Compared with warfarin, NOACs were superior and also reduced the risk of major bleeding.

“Warfarin use was superior to warfarin non-use, aspirin, and no antithrombotic therapy in reducing the risk of stroke/TE in older AF patients, but with a possible increase in major bleeding,” the researchers concluded. “NOACs were superior to warfarin for stroke/TE prevention, with reduced risk of majoring bleeding.”

--Melissa Weiss

Reference:

Ying B, Guo SD, Deng H, et al. Effectiveness and safety of oral anticoagulants in older patients with atrial fibrillation: a systematic review and meta-regression analysis. Age and Ageing. 2018;46(1): 9–17. https://doi.org/10.1093/ageing/afx103.