Arrhythmias & electrophysiology
Safety and effectiveness of direct oral anticoagulants in atrial fibrillation (AF) patients with nonmechanical valves
Authors' conclusion
This is the largest cohort of patients with NMV AF and DOACs to be described. Based on low event rates, our data support the prescribing of DOACs in this population.
Study context
- Population
- Patients with nonmechanical valvular (NMV) AF receiving direct oral anticoagulants (DOACs)patients included · dabigatran 100 · rivaroxaban 229 · apixaban 363
- Participants
- 692 patients
- Exposure
- Event rates were compared with those in patients with NVAF in the same databases
- NMV AFn = 692
- Outcome
- ischemic stroke or embolism
Methodological detailswithin administrative health care databases, included in a meta-analysis
- Within administrative health care databases
- Included in a meta-analysis
Main finding
As reported in the abstract
| Group | Value | Person-years |
|---|---|---|
| NMV AF | incidence rate 1.00 per 100 person-years (95% CI 0.48–2.10) | 699 |
| NVAF cohorts | incidence rate 0.83 per 100 person-years (95% CI 0.76–0.90) | 6707.58 |
Value
NMV AFincidence rate 1.00 per 100 person-years (95% CI 0.48–2.10)
NVAF cohortsincidence rate 0.83 per 100 person-years (95% CI 0.76–0.90)
Person-years
NMV AF699
NVAF cohorts6707.58
- NMV AF vs NVAF cohorts: P = 0.613
Observational data: associations, not effects.
Secondary outcomes
Comparison with other studies
- Event rates were overlapping with other studies
Safety
| Outcome | NMV AF | NVAF cohorts | P value |
|---|---|---|---|
| Major bleeding (secondary outcome)Incidence rate, per 100 person-years | 1.74 (95% CI 0.99–3.07) | 2.97 (95% CI 2.84–3.11) | P = 0.065 |
| Person-years | 689 | 64,178.27 |
Original publication
Safety and effectiveness of direct oral anticoagulants in AF patients with nonmechanical valves. Heart Rhythm. Published 30 June 2025. doi:10.
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