Arrhythmias & electrophysiologyCohort study
Switching from warfarin to direct oral anticoagulants in frail elderly Asian patients with atrial fibrillation: a Korean nationwide study
- Retrospective cohort study
- nationwide claims database
- time-varying exposure analysis
Authors' conclusion
In frail elderly Asian AF patients stably maintained on warfarin, switching to DOACs was associated with higher risks of adverse clinical events
Study context
- Population
- Frail elderly (≥75 years, Hospital Frailty Risk Score ≥5) Korean atrial fibrillation (AF) patients on warfarin without major bleeding or thromboembolic events, 2013–2015
- Participants
- 12,461 elderly · 11,842 person-years
- Exposure
- Switching from warfarin to DOAC vs remaining on warfarin
- DOACn = 3,349
- Warfarinn = 9,112reference
- Outcome
- Major bleeding
Main finding
As reported in the abstract
Hazard ratio
1.36
95% CI 1.01–1.81
DOAC vs Warfarin
HR 1.36 (95% CI 1.01–1.81)
Observational data: associations, not effects.
Secondary outcomes
| Outcome | HR (95% CI) | |
|---|---|---|
| Thromboembolic events | 1.61 (1.30–2.00) | |
| Net clinical outcome (major bleeding + thromboembolic events) | 1.58 (1.29–1.94) | |
| All-cause death | 1.20 (1.02–1.42) | |
| 0.512Hazard ratio (log scale) |
All outcomes, subgroups
- DOAC treatment tended to show higher risks of all outcomes vs warfarin
Original publication
Switching from warfarin to direct oral anticoagulants in frail elderly Asian patients with atrial fibrillation: a Korean nationwide study. Eur Heart J. Published 27 February 2026. doi:10.1093/eurheartj/ehaf999
Summarised from the published abstract; every number is checked against it