Author + information
- Steve Deitelzweig,
- Allison Keshishian,
- Xiaoyan Li,
- Melissa Hamilton,
- Cristina Masseria,
- Kiran Gupta,
- Xuemei Luo,
- Jack Mardekian,
- Keith Friend,
- Anagha Nadkarni,
- Xianying Pan,
- Onur Baser and
- Gregory Y.H. Lip
Most observational studies on direct oral anticoagulants (DOACs) used single data sources with limited generalizability. This ARISTOPHANES (Anticoagulants for Reduction In STroke: Observational Pooled analysis on Health outcomes ANd Experience of patientS) study aimed to use multiple data sources to compare stroke/systemic embolism (S/SE), major bleeding (MB), and net clinical outcome (composite of S/SE and MB) among a large number of non-valvular atrial fibrillation (NVAF) patients on different DOACs.
A retrospective observational study of NVAF patients initiating apixaban, dabigatran, or rivaroxaban from 01/01/2013-09/30/2015 was conducted pooling CMS Medicare data and 4 US commercial claims databases - which covers >180 million beneficiaries annually (∼56% of the US population). After 1:1 DOAC-DOAC propensity score matching in each database, the resulting patient records were pooled. Cox models were used to evaluate the risk of S/SE, MB, and the net clinical outcome (identified using inpatient claims) across DOACs within 1 year of therapy initiation.
The study included 162,707 patients followed for a mean of 6 months. Results are shown in Figure 1.
In this largest observational study to date on DOAC-DOAC comparisons, apixaban was associated with a lower risk of S/SE, MB, and net clinical outcome compared to dabigatran and rivaroxaban; dabigatran was associated with a lower risk of MB and net clinical outcome compared to rivaroxaban.
Room 314 A
Sunday, March 11, 2018, 8:51 a.m.-9:01 a.m.
Session Title: Highlighted Original Research: Arrhythmias and Clinical EP and the Year in Review
Abstract Category: 06. Arrhythmias and Clinical EP: Other
Presentation Number: 900-10
- 2018 American College of Cardiology Foundation