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A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
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01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
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20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
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Long-term outcomes of vitamin K antagonists versus direct oral anticoagulation
Session:
Posters - C. Arrhythmias and Device Therapy
Speaker:
João Baltazar Ferreira
Congress:
CPC 2021
Topic:
C. Arrhythmias and Device Therapy
Theme:
05. Atrial Fibrillation
Subtheme:
05.5 Atrial Fibrillation - Stroke Prevention
Session Type:
Posters
FP Number:
---
Authors:
João Baltazar Ferreira; Marco Beringuilho; Daniel Faria; João Bicho Augusto; David Roque; Inês Fialho; Miguel Santos; Mariana Passos; Carlos Morais
Abstract
<p>Background<br /> Atrial fibrillation (AF) is a well-known cause of adverse outcomes. We aimed to compare adverse outcomes at 3 years follow-up in patients with AF under vitamin K antagonists (AVK) versus direct oral anticoagulants (DOACs).</p> <p>Methods<br /> 2181 consecutive patients with AF who were evaluated in our emergency department (ED) in a 12-month period were included retrospectively in our study. Among them, 423 patients were admitted for in-hospital management. We reviewed all medical charts before discharge and recorded which oral anticoagulant was prescribed (AVK or DOAC – dabigatran, rivaroxaban or apixaban). Primary outcomes were defined as all-cause mortality and stroke at 3 years follow-up after discharge.</p> <p>Results<br /> 247 patients were successfully discharged under oral anticoagulation; mean age was 70.8 ± 0.7 years, 36.8% were males. Follow-up was possible in 98.5% of our population. Stroke rate was 7.3% (n=18) and all-cause mortality was 26% (n=64). Stroke rate was not significantly different between AVKs and DOACs (8.5 vs 6.6%, respectively, p=0.619). However, death rate was significantly higher in patients under AVK therapy (36.2 vs 19.7%, p=0.007). Kaplan-Meyer curves of survival according to AVK vs DOAC therapy are shown in figure. No significant differences in stroke (p=0.209) or death rates (p=0.793) were found between different DOACs.</p> <p>Conclusion<br /> In patients with AF, AVKs were associated with rates of stroke that were similar to DOACs, but increased rates of all-cause mortality.</p>
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