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- W2341942268 abstract "Vitamin K antagonists, such as warfarin, have been used for years for prevention of stroke in patients with atrial fi brillation. However, the use of these drugs has been limited by interpatient and intrapatient variability, the need for laboratory monitoring, and important interactions with food and other drugs. 1 During the last few years, non-vitamin K antagonist oral anticoagulants (NOACs) have emerged as alternatives to vitamin K antagonists, with some studies showing better effi cacy, safety, and convenience for patients with atrial fi brillation. 2 Although NOACs might have some advantages over vitamin K antagonists, some concerns have emerged about whether patients switching from a vitamin K antagonist to a NOAC might have higher risks of thromboembolism and bleeding. 3,4 Data from another study 5 have also suggested that switchers might have a higher risk of myocardial infarction. The reasons are uncertain but could possibly be associated with patients who have many comorbidities and problems with drug adherence that result from being switched from a vitamin K antagonist to a NOAC. In The Lancet Haematology, Bouillon and colleagues 6 show that switching patients from a vitamin K antagonist to a NOAC did not increase their risk of bleeding compared with patients with atrial fi brillation who were maintained on a vitamin K antagonist (hazard ratio [HR] 0·87; 95% CI 0·67–1·13, p=0·54). The absence of an increase in risk was irrespective of NOAC type. Additionally in this large, real-world matched-cohort study, no signifi cant increase in the risk of ischaemic stroke, systemic embolism, or myocardial infarction was noted for switchers versus non-switchers. Bouillon and colleagues highlight several issues in their study. 6" @default.
- W2341942268 created "2016-06-24" @default.
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- W2341942268 date "2015-01-01" @default.
- W2341942268 modified "2023-09-27" @default.
- W2341942268 title "Switching from a vitamin K antagonist to a NOAC" @default.
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