학술논문
Comparison of Direct Oral Anticoagulants and Warfarin in Patients With Atrial Fibrillation and an Aortic Bioprosthetic Valve
Document Type
Journal Article
Author
Atsushi Iwakura; Atsushi Takita; Chisato Izumi; Hidekazu Tanaka; Hiroya Kawai; Kenichi Tsujita; Kenji Ando; Kenji Minatoya; Kiyoshi Yoshida; Kiyoyuki Eishi; Kumiko Sugio; Kunihiro Nishimura; Makoto Miyake; Masaki Izumo; Masashi Amano; Misa Takegami; Ryuzo Nawada; Tadaaki Koyama; Takeshi Kimura; Takeshi Kitai; Tatsuhiko Komiya; Tetsuya Kimura; Tomohiro Sakamoto; Tomoyuki Fujita; Toshihiro Fukui; Toshihiro Tamura; Yasushi Sakata; Yoshisato Shibata; Yuki Obayashi; Yutaka Furukawa; for the BPV-AF Registry Group
Source
Circulation Journal. 0226
Subject
Language
English
ISSN
1346-9843
1347-4820
1347-4820
Abstract
Methods and Results: This post-hoc subgroup analysis of a multicenter, prospective, observational registry (BPV-AF Registry) aimed to compare DOACs and warfarin in AF patients with an aortic BPV. The primary outcome was a composite of stroke, systemic embolism, major bleeding, heart failure requiring hospitalization, all-cause death, or BPV reoperation. The analysis included 479 patients (warfarin group, n=258; DOAC group, n=221). Surgical aortic valve replacement was performed in 74.4% and 36.7% of patients in the warfarin and DOAC groups, respectively. During a mean follow up of 15.5 months, the primary outcome occurred in 45 (17.4%) and 32 (14.5%) patients in the warfarin and DOAC groups, respectively. No significant difference was found in the primary outcome between the 2 groups (adjusted hazard ratio: 0.88, 95% confidence interval: 0.51–1.50). No significant multiplicative interaction was observed between the anticoagulant effects and type of aortic valve procedure (P=0.577).