ArticleEuropean heart journal. Quality of care & clinical outcomes2022
Effectiveness and safety of non-vitamin K antagonist oral anticoagulants and warfarin in atrial fibrillation: a Scandinavian population-based cohort study.
Article in European heart journal. Quality of care & clinical outcomes, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 3 of them syntheses that pooled it.
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Who cites it
9 citing papers in PubMed, 3 syntheses or guidelines pooled it, 14 citations in OpenAlex.
- Real-world evidence comparing oral anticoagulants for NVAF in Europe: a systematic review and network meta-analysis.Future cardiology · 2025Pooled it
- Effectiveness and Safety of Dose-Specific DOACs in Patients With Atrial Fibrillation: A Systematic Review and Network Meta-Analysis.Cardiovascular therapeutics · 2025Pooled it
- Oral Anticoagulation Therapy in Atrial Fibrillation Patients with Intermediate Stroke Risk: A Systematic Review and Meta-Analysis.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisPooled it
- Comparative safety of direct oral anticoagulants and low-molecular-weight heparin in patients with venous thromboembolism and cancer in Europe.Journal of comparative effectiveness research · 2026Observational
- ICD-10 code validation for gastrointestinal bleeding in patients receiving oral anticoagulation: nationwide cohort study.BMC gastroenterology · 2025Article
- Core Concepts in Pharmacoepidemiology: Multi-Database Distributed Data Networks.Pharmacoepidemiology and drug safety · 2025Review
- Health-related quality of life among transthyretin amyloid cardiomyopathy patients.ESC heart failure · 2023Article
- Long-term comparative effectiveness and safety of dabigatran, rivaroxaban, apixaban and edoxaban in patients with atrial fibrillation: A nationwide cohort study.Frontiers in pharmacology · 2023Article
- Risk Profiles of New Users of Oral Anticoagulants Between 2011 and 2019 in Germany.Clinical epidemiology · 2023Article
Corrections and comments
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Authors and funding
12 authors at 11 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsUsing Scandinavian population-based registries, we assessed risk of stroke/systemic embolism (SE) and bleeding with non-vitamin K antagonist oral anticoagulants compared with warfarin in anticoagulation-naïve patients with atrial fibrillation (AF). METHODS AND
resultsThis historical cohort study included 219 545 AF patients [median age 74 years; 43% women; mean CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke or transient ischaemic attack, vascular disease, age 65-74 years, sex category) score 3.3] initiating apixaban, dabigatran, rivaroxaban, or warfarin in Denmark, Norway, and Sweden (1 January 2013 to 31 December 2016). The primary endpoints were stroke/SE and major bleeding. The median follow-up times were 9.7 (3.9-21.5) months for stroke/SE and 9.6 (3.8-21.3) months for bleeding. Apixaban and warfarin initiators were older and had higher CHA2DS2-VASc scores compared with dabigatran and rivaroxaban initiators. After 1:1 propensity score matching, three cohorts were created: apixaban-warfarin (n = 111 162), dabigatran-warfarin (n = 56 856), and rivaroxaban-warfarin (n = 61 198). Adjusted hazard ratios (HRs) were estimated using a Cox regression. For stroke/SE, adjusted HRs against warfarin were 0.96 [95% confidence interval (CI): 0.87-1.06] for apixaban, 0.89 (95% CI: 0.80-1.00) for dabigatran, and 1.03 (95% CI: 0.92-1.14) for rivaroxaban. For major bleeding, the HRs against warfarin were 0.73 (95% CI: 0.67-0.78) for apixaban, 0.89 (95% CI: 0.82-0.97) for dabigatran, and 1.15 (95% CI: 1.07-1.25) for rivaroxaban. The results in the dabigatran cohort did not hold in all dose-defined subgroups.
conclusionIn this large Scandinavian study among AF patients initiating oral anticoagulation, those initiating dabigatran, apixaban, and rivaroxaban had similar rates of stroke/SE to patients initiating warfarin. Rates of major bleeding were lower with apixaban and dabigatran and higher with rivaroxaban, each compared with warfarin.
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