Comparison of the real-life clinical outcomes of warfarin with effective time in therapeutic range and non-vitamin K antagonist oral anticoagulants: Insight from the AFTER-2 trial

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dc.contributor.authorAktan, Adem
dc.contributor.authorGuzel, Tuncay
dc.contributor.authorAslan, Burhan
dc.contributor.authorKilic, Raif
dc.contributor.authorGunlu, Serhat
dc.contributor.authorOzbek, Mehmet
dc.contributor.authorArslan, Bayram
dc.date.accessioned2024-04-24T17:20:53Z
dc.date.available2024-04-24T17:20:53Z
dc.date.issued2023
dc.departmentDicle Üniversitesien_US
dc.description.abstractBackground: It is unclear whether warfarin treatment with high time in therapeutic range (TTR) is as effective and safe as non-vitamin K antagonist oral anticoagulants (NOACs). It is crucial to compare warfarin with effective TTR and NOACs to predict long-term adverse events in patients with atrial fibrillation. Aims: We aimed to compare the long-term follow-up results of patients with atrial fibrillation (AF) who use vitamin K antagonists (VKAs) with effective TTR and NOACs. Methods: A total of 1140 patients were followed at 35 different centers for five years. During the follow-up period, the international normalized ratio (INR) values were studied at least 4 times a year, and the TTR values were calculated according to the Roosendaal method. The effective TTR level was accepted as >60% as recommended by the guidelines. There were 254 patients in the effective TTR group and 886 patients in the NOAC group. Ischemic cerebrovascular disease/transient ischemic attack (CVD/TIA), intracranial bleeding, and mortality were considered primary endpoints based on one-year and five-year follow-ups. Results: Ischemic CVD/TIA (3.9% vs. 6.2%; P = 0.17) and intracranial bleeding (0.4% vs. 0.5%; P = 0.69), the one-year mortality rate (7.1% vs. 8.1%; P = 0.59), the five-year mortality rate (24% vs. 26.3%; P = 0.46) were not different between the effective TTR and NOACs groups during the follow-up, respectively. The CHA2DS2-VASC score was similar between the warfarin with effective TTR group and the NOAC group (3 [2-4] vs. 3 [2-4]; P = 0.17, respectively). Additionally, survival free-time did not differ between the warfarin with effective TTR group and each NOAC in the Kaplan-Meier analysis (dabigatran; P = 0.59, rivaroxaban; P = 0.34, apixaban; P = 0.26, and edoxaban; P = 0.14). Conclusion: There was no significant difference in primary outcomes between the effective TTR and NOAC groups in AF patients.en_US
dc.identifier.doi10.33963/KP.a2022.0287
dc.identifier.endpage140en_US
dc.identifier.issn0022-9032
dc.identifier.issn1897-4279
dc.identifier.issue2en_US
dc.identifier.pmid36594528
dc.identifier.scopus2-s2.0-85149427071
dc.identifier.scopusqualityQ3
dc.identifier.startpage132en_US
dc.identifier.urihttps://doi.org/10.33963/KP.a2022.0287
dc.identifier.urihttps://hdl.handle.net/11468/19289
dc.identifier.volume81en_US
dc.identifier.wosWOS:000944156200001
dc.identifier.wosqualityN/A
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoenen_US
dc.publisherPolish Cardiac Socen_US
dc.relation.ispartofKardiologia Polska
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectAnticoagulantsen_US
dc.subjectAtrial Fibrillationen_US
dc.subjectInternational Normalized Ratiosen_US
dc.subjectWarfarinen_US
dc.titleComparison of the real-life clinical outcomes of warfarin with effective time in therapeutic range and non-vitamin K antagonist oral anticoagulants: Insight from the AFTER-2 trialen_US
dc.titleComparison of the real-life clinical outcomes of warfarin with effective time in therapeutic range and non-vitamin K antagonist oral anticoagulants: Insight from the AFTER-2 trial
dc.typeArticleen_US

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