Stroke: Analysis of oral anticoagulant efficacy of non-vitamin K antagonists in patients with atrial fibrillation with gastrointestinal bleeding in the past

Support for non-vitamin K oral anticoagulant drugs (NOACs) has limited data on the protective effects of atrial fibrillation in patients with a history of gastrointestinal bleeding (GIB).
recently published a study in the authoritative journalStroke on Cardiovascular Disease, in which researchers assessed the effectiveness and safety of taking NOACs in patients with atrial fibrillation with a history of GIB and compared them to warfarin.
researchers identified atrial fibrillation patients who had no oral anticoagulant treatment between January 2010 and April 2018 from the Korean claims database and had a history of GIB.
the researchers used therapeutic weighted anti-probability balanced covariances to compare NOAC takers with huafarin takers.
the main endpoints of the study were ischemic stroke, haemorrhage, and compound endpoints (ischemic stroke combined with haemorrhage).
the fatal event in each result as a secondary outcome.
the study included 42,048 patients (24,781 in noAC and 17,267 in Huafarin).
interval between gib and the on-start oral anticoagulant was 3.1±2.6 years.
after treatment-weighted inverse probability analysis, the baseline characteristics were balanced between the two groups (average age was 72 years; male was 56.8%; and CHA2DS2-VASc had an average score of 3.7).
the use of NOAC reduces the risk of ischemic stroke, haemorrhage and comprehensive prognosis compared to the use of huafalin (weighted risk ratio is 0.608 (95% CI is 0.543-0.680); The ratio is 0.731 (95% CI is 0.642-0.832) and the risk ratio is 0.661 (95% CI is 0.606-0.721).
, noACs are more risk-reducing than Warfarin for all secondary outcomes.
result, patients with a history of GIB atrial fibrillation had a lower risk of ischemic stroke and haemorrhage than those who took NOACs.