ArticleJournal of the American Heart Association2025
Direct Oral Anticoagulants Compared With Warfarin in Patients With Atrial Fibrillation and Valvular Heart Disease Without Mechanical Valves.
Article in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
6 citing papers in PubMed.
- Targeting Neurovascular Pathways: Gene Therapy as a Novel Treatment for Vascular Dementia After Stroke.Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society · 2026Review
- Comparative evaluation of surgicel and gelfoam in controlling post-extraction bleeding in patients on anticoagulant therapy: a clinical study.BMC oral health · 2025Article
- Review
- Review
- Anticoagulation in Atrial Fibrillation With Valvular Heart Disease.Journal of the American Heart Association · 2025Article
- Impact of anticoagulation on cognitive decline and clinical outcomes in patients with atrial fibrillation and dementia: A retrospective cohort study.Journal of Alzheimer's disease reportsArticle
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3 authors.
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Abstract
backgroundDespite proven efficacy and safety of direct oral anticoagulants (DOACs) over warfarin in patients with atrial fibrillation (AF), data on patients with AF and valvular heart disease remain scarce. We aimed to evaluate the DOACs compared with warfarin among patients with AF and valvular heart disease. METHODS AND
resultsWe conducted a retrospective cohort study of patients ≥18 years of age, who had AF and valvular heart disease, and were new users of DOACs or warfarin. The primary effectiveness outcomes were ischemic stroke or systemic embolism, and bleeding for safety. We used Cox proportional-hazards regression after propensity score matching to estimate hazard ratios (HRs) and 95% CIs. In the matched cohort, DOAC use (versus warfarin) was associated with a lower rate of ischemic stroke or systemic embolism (HR, 0.70 [95% CI, 0.61-0.81]) and bleeding (HR, 0.72 [95% CI, 0.65-0.80]). We found a lower rate of ischemic stroke or systemic embolism with rivaroxaban (HR, 0.74 [95% CI, 0.62-0.89]) and apixaban (HR, 0.62 [95% CI, 0.52-0.74]) but not dabigatran (HR, 0.89 [95% CI, 0.63-1.26]). We found a lower rate of bleeding with rivaroxaban (HR, 0.84 [95% CI, 0.74-0.95]), apixaban (HR, 0.60 [95% CI, 0.53-0.68]), dabigatran (HR, 0.75 [95% CI, 0.58-0.97]), and edoxaban (HR, 0.21 [95% CI, 0.05-0.83]). We were unable to obtain estimates for the effectiveness outcome with edoxaban due to the small number of events.
conclusionsIn this study of patients with AF and valvular heart disease, DOAC treatment was associated with a lower risk of ischemic stroke or systemic embolism and bleeding compared with warfarin.
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