Arrhythmias & electrophysiology
Oral Anticoagulation in Patients with Hypertrophic Cardiomyopathy and Non-Valvular Atrial Fibrillation in Japan
Authors' conclusion
DOAC-treated patients had a lower risk of stroke/SE and a comparable risk of bleeding compared with warfarin-treated patients.
Study context
- Population
- Patients in Japan diagnosed with hypertrophic cardiomyopathy (HCM) and non-valvular AF, July 2011–June 2021 (Japanese claims database)after propensity score (PS) matching
- Participants
- 2,955 vs 1,603
- Exposure
- Direct oral anticoagulant (DOAC) vs warfarin
- DOACn = 2,955
- Warfarinn = 1,603reference
- Outcome
- Major bleeding and any bleeding (major or minor)
Methodological detailspropensity-score matched (2:1 DOAC:warfarin), claims database
- Propensity-score matched (2:1 DOAC:warfarin)
- Claims database
Main finding
As reported in the abstract
Major bleeding; any bleeding
DOAC vs WarfarinHazard ratio (95% CI)P value
Major bleeding
0.80(0.50–1.27)
P = 0.336Any bleeding
0.93(0.78–1.11)
P = 0.420Observational data: associations, not effects.
Secondary outcomes
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Stroke/systemic embolism | 0.67 (0.47–0.96) | P = 0.027 | |
| 0.512Hazard ratio (log scale) |
Factors associated with increased major bleeding risk
- Prior bleeding, HR
- 1.97 (95% CI 1.22-3.17)
- CKD, HR
- 1.87 (95% CI 1.10-3.18)
Factors associated with increased stroke/SE risk
- Prior ischaemic stroke, HR
- 2.97 (95% CI 2.05-4.29)
- PAD, HR
- 1.88 (95% CI 1.22-2.88)
- CKD, HR
- 1.87 (95% CI 1.24-2.83)
Safety
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Major bleeding; any bleeding (primary outcomes)DOAC vs Warfarin · major bleeding | 0.80 (0.50–1.27) | P = 0.336 | |
| Major bleeding; any bleeding (primary outcomes)DOAC vs Warfarin · any bleeding | 0.93 (0.78–1.11) | P = 0.420 | |
| 0.512Hazard ratio (log scale) |
Original publication
Oral Anticoagulation in Patients with Hypertrophic Cardiomyopathy and Non-Valvular Atrial Fibrillation in Japan. ESC Heart Fail. Published 19 September 2024. doi:10.
Summarised from the published abstract; every number is checked against it