Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

ENGAGE AF-TIMI: Insulin linked to greater risk for stroke, CV death, bleeding

Key clinical point: Use of novel oral anticoagulants may be preferred over vitamin K antagonists in patients with diabetes and atrial fibrillation.

Major finding: Patients with diabetes were at higher adjusted risk than were patients without diabetes for CV death (hazard ratio, 1.29), major adverse cardiac event (HR, 1.28), major bleed (HR, 1.28), and the net outcome of stroke, systemic embolic event, major bleed, or all-cause death (HR, 1.25).

Study details: A subanalysis of 7,624 patients with diabetes in the ENGAGE AF-TIMI 48 trial receiving warfarin or 60 mg edoxaban.

Disclosures: Dr. Plitt disclosed having received honoraria for educational activities from Bristol-Myers Squibb.


Plitt A et al. WCIRDC 2019.