Clinical Edge

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

The Benefits of OAC in Patients With AF

J Am Heart Assoc; ePub 2018 Jan 4; Gray, et al

In patients with atrial fibrillation (AF) and newly recommended for oral anticoagulation (OAC) under the 2014 AHA/ACC/HRS guideline, the benefit of OAC is not fully defined, with no difference observed in the risk of stroke, systemic embolism, and death between users and nonusers. The study identified patients with initially diagnosed AF between 2013 and 2014 and selected those who would receive OAC under the 2014 guidelines but not the 2011 guidelines. Patients were categorized according to use of OAC after first AF diagnosis (n=2,937 users; n=2,914 nonusers). The primary outcomes included the composite of ischemic stroke, systemic embolism and death, and any bleeding event. Among the findings:

  • There was no difference in the combined risk of stroke, systemic embolism, and death between treatment groups (HR, 1.00).
  • The risk of bleeding was higher for patients receiving OAC vs patients not receiving OAC (HR, 1.70).

Citation:

Gray MP, Saba S, Zhang Y, Hernandez I. Outcomes of patients with atrial fibrillation newly recommended for oral anticoagulation under the 2014 American Heart Association/American College of Cardiology/Heart Rhythm Society guideline. [Published online ahead of print January 4, 2018]. J Am Heart Assoc. doi:10.1161/JAHA.117.007881.

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