Clinical Electrophysiology -> Atrial Fibrillation & Atrial Flutter: -> Pharmacology (Antiarrhythmic drugs and anticoagulants) D-AB26 - Refining Stroke Prevention in Atrial Fibrillation (ID 13) Abstract

D-AB26-06 - Effectiveness And Safety Of Anticoagulation In Nonvalvular Atrial Fibrillation Patients With A Non-sex-related Cha2ds2-va Score Of 0 Or 1 (ID 805)

Disclosure

 C. Kwon: Nothing relevant to disclose.

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Abstract

Background: There are limited real-world data on the effectiveness and safety of anticoagulation in nonvalvular atrial fibrillation (NVAF) patients with a non-sex-related CHA2DS2-VA score of 0 or 1.
Objective: We aimed to compare the effectiveness and safety outcomes of anticoagulant treatment and no treatment in this population.
Methods: Using datasets form the Asan BiomedicaL research Environment database (between 1998 and 2017), this study comprised 5,567 NVAF patients with a non-sex-related CHA2DS2-VA score of 0 and 5,039 with a score of 1. Study patients were divided into treatment or control groups according to prescription of warfarin or non-vitamin K oral anticoagulants. Primary outcomes included stroke or systemic embolism and major bleeding.
Results: During the median follow-up of 17.3 months, anticoagulant treatment was associated with a similar risk of stroke or systemic embolism in comparison with control (hazard ratio [HR], 1.11; 95% confidence intervals [CI], 0.56-2.17) in patients with a score of 0, and with a non-significantly lower risk (HR, 0.58; 95% CI, 0.31-1.09) in those with a score of 1. Regarding safety outcomes, anticoagulant treatment had a non-significantly higher risk of major bleeding in comparison with control (HR, 1.43; 95% CI, 0.61-3.34) in patients with a score of 0, but the risk was similar (HR, 0.95; 95% CI, 0.50-1.90) in those with a score of 1. Among patients aged 65-74 years, anticoagulant treatment was associated with a significantly lower risk of stroke or systemic embolism in comparison with control (HR, 0.42; 95% CI, 0.18-0.98, P value = 0.046).
Conclusion: In an NVAF patients with a non-sex-related CHA2DS2-VA score of 0 or 1, anticoagulant treatment was associated with a non-significantly lower risk of stroke or systemic embolism in comparison with control, with no effect on major bleeding. Among patients with a non-sex-related CHA2DS2-VA score of 1, anticoagulant treatment was associated with a significant reduction of the incidence of stroke and systemic embolism versus control in patients aged 65-74 years.

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