European Heart Journal - Cardiovascular Pharmacotherapy, Volume 5, Issue 2, April 2019, Pages 80–90
Dr Villines and co-workers from the USA used the US Department of Defense Military Health System database to compare the safety and effectiveness of direct oral anticoagulants (DOACs) in patients with NVAF initiating dabigatran vs. rivaroxaban or apixaban. Propensity score matching identified two well-balanced cohorts (dabigatran vs. rivaroxaban n = 12 763 per treatment group; dabigatran vs. apixaban n = 4802 per treatment group). The authors concluded that among NVAF patients, newly initiated on standard-dose DOAC therapy, dabigatran was associated with significantly lower major bleeding risk vs. rivaroxaban, and no significant difference in stroke risk. For dabigatran vs. apixaban, the reduced sample size limited the ability to draw definitive conclusions. Thus, bleeding rates may differ between the oral anticoagulant drugs.
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