Skip to main content
  • American Heart Association
  • Science Volunteer
  • Warning Signs
  • Advanced Search
  • Donate

  • Home
  • About this Journal
    • Editorial Board
    • General Statistics
    • Circulation Doodle
      • Doodle Gallery
      • Circulation Cover Doodle
        • → Blip the Doodle
    • Information for Advertisers
    • Author Reprints
    • Commercial Reprints
    • Customer Service and Ordering Information
    • Subscribe to AHA Journals
  • All Issues
  • Subjects
    • All Subjects
    • Arrhythmia and Electrophysiology
    • Basic, Translational, and Clinical Research
    • Critical Care and Resuscitation
    • Epidemiology, Lifestyle, and Prevention
    • Genetics
    • Heart Failure and Cardiac Disease
    • Hypertension
    • Imaging and Diagnostic Testing
    • Intervention, Surgery, Transplantation
    • Quality and Outcomes
    • Stroke
    • Vascular Disease
  • Browse Features
    • AHA Guidelines and Statements
      • Recently Published Guidelines
    • Bridging Disciplines
    • Circulation at Major Meetings
    • Special Themed Issues
    • Global Impact of the 2017 ACC/AHA Hypertension Guidelines
    • Circulation Supplements
    • Cardiovascular Case Series
    • ECG Challenge
    • Hospitals of History
      • Brigham and Women's Hospital
      • Hartford Hospital
      • Hospital Santa Maria del Popolo, Naples, Italy
      • Instituto do Coração-INCOR (São Paulo, Brasil)
      • Minneapolis City Hospital
      • Parkland Hospital: Dallas, Texas
      • Pennsylvania Hospital, Philadelphia
      • Pitié-Salpêtrière Hospital
      • Royal Infirmary of Edinburgh, Scotland
      • Tufts Medical Center
      • University of Michigan
      • Uppsala University Hospital
      • Vassar Brothers Medical Center (Poughkeepsie, NY)
      • Wroclaw Medical University
      • Women's College Hospital, Toronto, Canada
      • Henry Ford Hospital, Detroit, Michigan
      • Instituto Nacional de Cardiología Ignacio Chávez – INCICh México City, México
      • Kuang-Tien General Hospital (Taichug, Taiwan)
    • On My Mind
    • Podcast Archive
    • → Subscribe to Circulation on the Run
    • →Circulation FIT Podcast 2018
    • → #FITFAVs
  • Resources
    • Instructions for Authors
      • Accepted Manuscripts
      • Revised Manuscripts
    • → Article Types
    • → General Preparation Instructions
    • → Research Guidelines
    • → How to Submit a Manuscript
    • Journal Policies
    • Permissions and Rights Q&A
    • Submission Sites
    • Circulation CME
    • AHA Journals RSS Feeds
    • International Users
    • AHA Newsroom
  • AHA Journals
    • AHA Journals Home
    • Arteriosclerosis, Thrombosis, and Vascular Biology (ATVB)
    • Circulation
    • → Circ: Arrhythmia and Electrophysiology
    • → Circ: Genomic and Precision Medicine
    • → Circ: Cardiovascular Imaging
    • → Circ: Cardiovascular Interventions
    • → Circ: Cardiovascular Quality & Outcomes
    • → Circ: Heart Failure
    • Circulation Research
    • Hypertension
    • Stroke
    • Journal of the American Heart Association
  • Facebook
  • Twitter

  • My alerts
  • Sign In
  • Join

  • Advanced search

Header Publisher Menu

  • American Heart Association
  • Science Volunteer
  • Warning Signs
  • Advanced Search
  • Donate

Circulation

  • My alerts
  • Sign In
  • Join

  • Facebook
  • Twitter
  • Home
  • About this Journal
    • Editorial Board
    • General Statistics
    • Circulation Doodle
    • Information for Advertisers
    • Author Reprints
    • Commercial Reprints
    • Customer Service and Ordering Information
    • Subscribe to AHA Journals
  • All Issues
  • Subjects
    • All Subjects
    • Arrhythmia and Electrophysiology
    • Basic, Translational, and Clinical Research
    • Critical Care and Resuscitation
    • Epidemiology, Lifestyle, and Prevention
    • Genetics
    • Heart Failure and Cardiac Disease
    • Hypertension
    • Imaging and Diagnostic Testing
    • Intervention, Surgery, Transplantation
    • Quality and Outcomes
    • Stroke
    • Vascular Disease
  • Browse Features
    • AHA Guidelines and Statements
    • Bridging Disciplines
    • Circulation at Major Meetings
    • Special Themed Issues
    • Global Impact of the 2017 ACC/AHA Hypertension Guidelines
    • Circulation Supplements
    • Cardiovascular Case Series
    • ECG Challenge
    • Hospitals of History
    • On My Mind
    • Podcast Archive
    • → Subscribe to Circulation on the Run
    • →Circulation FIT Podcast 2018
    • → #FITFAVs
  • Resources
    • Instructions for Authors
    • → Article Types
    • → General Preparation Instructions
    • → Research Guidelines
    • → How to Submit a Manuscript
    • Journal Policies
    • Permissions and Rights Q&A
    • Submission Sites
    • Circulation CME
    • AHA Journals RSS Feeds
    • International Users
    • AHA Newsroom
  • AHA Journals
    • AHA Journals Home
    • Arteriosclerosis, Thrombosis, and Vascular Biology (ATVB)
    • Circulation
    • → Circ: Arrhythmia and Electrophysiology
    • → Circ: Genomic and Precision Medicine
    • → Circ: Cardiovascular Imaging
    • → Circ: Cardiovascular Interventions
    • → Circ: Cardiovascular Quality & Outcomes
    • → Circ: Heart Failure
    • Circulation Research
    • Hypertension
    • Stroke
    • Journal of the American Heart Association
Abstracts and presentations are embargoed for release at date and time of presentation or time of AHA/ASA news event. Failure to honor embargo policies (http://newsroom.heart.org/newsmedia/embargo-policy) will result in the abstract being withdrawn and barred from presentation.
Quality of Care and OutcomesSession Title: Heart Failure and Atrial Fibrillation

Abstract 11938: Long-term Population-based Outcomes of Novel Oral Anticoagulants Compared to Warfarin Among Long-term Anticoagulated Patients: A Propensity Matched Analysis

Victoria Jacobs, Heidi T May, Tami L Bair, Jeffrey L Anderson, Brian G Crandall, Michael Cutler, John D Day, Charles D Mallender, Jeffrey S Osborn, Scott M Stevens, J P Weiss, Scott C Woller, T J Bunch
Circulation. 2015;132:A11938
Victoria Jacobs
Intermountain Heart Institute, Intermountain Med Cntr, Murray, UT
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Heidi T May
Intermountain Heart Institute, Intermountain Med Cntr, Murray, UT
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Tami L Bair
Intermountain Heart Institute, Intermountain Med Cntr, Murray, UT
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jeffrey L Anderson
Intermountain Heart Institute, Intermountain Med Cntr, Univ of Utah, Murray, UT
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Brian G Crandall
Intermountain Heart Institute, Intermountain Med Cntr, Murray, UT
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Michael Cutler
Intermountain Heart Institute, Intermountain Med Cntr, Murray, UT
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
John D Day
Intermountain Heart Institute, Intermountain Med Cntr, Murray, UT
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Charles D Mallender
Intermountain Heart Institute, Intermountain Med Cntr, Murray, UT
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jeffrey S Osborn
Intermountain Heart Institute, Intermountain Med Cntr, Murray, UT
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Scott M Stevens
Intermountain Heart Institute, Intermountain Med Cntr, Murray, UT
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
J P Weiss
Intermountain Heart Institute, Intermountain Med Cntr, Murray, UT
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Scott C Woller
Intermountain Heart Institute, Intermountain Med Cntr, Murray, UT
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
T J Bunch
Intermountain Heart Institute, Intermountain Med Cntr, Murray, UT
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Info & Metrics

Jump to

  • Article
  • Info & Metrics
  • eLetters
Loading

Abstract

Introduction: Novel oral anticoagulants (NOACs) have been used in clinical practice in the US for the last 4 years. While NOACs may be an attractive alternative to warfarin among many patients, long-term outcomes of use of these medications are unknown. We performed a propensity matched analysis of long-term outcomes among patients taking a NOAC or warfarin.

Hypothesis: NOACs will be superior to warfarin for the reduction of long-term outcomes.

Methods: Patients receiving long-term anticoagulation between June 2010 and December 2014 for thromboembolism prevention with either warfarin or a single NOAC were matched 1:1 by index date (± 6 months) and propensity score (±0.01). Multivariable Cox hazard regression was performed to determine the risk of death, stroke/TIA, major bleed, and bleed by the anticoagulant therapy received.

Results: Patients studied included: apixaban: 590, dabigatran: 583, rivaroxaban: 1, 454. A total of 5,254 patients were studied (2,627 per group). Average age was 72.4±10.9 and 59.0% were male. The majority of patients were receiving long-term anticoagulation for AF management (warfarin: 96.5% vs. NOAC: 92.7%, p<0.0001). Rivaroxaban (n=1,454 [55.3%]) was the most commonly used NOAC, (apixaban=590 [22.5%], dabigatran=583 [22.2%]). History of stroke/TIA and prior bleed were similar between the groups, yet more NOAC patients formally had major bleeding (9.2% vs. 6.8%, p=0.002). The use of NOACs compared to warfarin were associated with a reduced risk of long-term adverse outcomes [Figure, death (p=0.09), stroke/TIA (p<0.0001), major bleed (p<0.0001), and bleed (p=0.14)]. No significant outcome variance was noted in NOAC type comparison.

Conclusions: Our community-based results are support better long-term efficacy and safety of NOACs compared to warfarin, and are in agreement with the shorter-term results of previous clinical trials.


Embedded Image
  • Anticoagulants
  • Warfarin
  • Outcomes
  • Author Disclosures: V. Jacobs: None. H.T. May: None. T.L. Bair: None. J.L. Anderson: None. B.G. Crandall: None. M. Cutler: None. J.D. Day: None. C.D. Mallender: None. J.S. Osborn: None. S.M. Stevens: None. J.P. Weiss: None. S.C. Woller: None. T.J. Bunch: None.

  • © 2015 by American Heart Association, Inc.
Back to top
Previous Article

This Issue

Circulation
November 10, 2015, Volume 132, Issue Suppl 3
  • Table of Contents
Previous Article

Jump to

  • Article
  • Info & Metrics

Article Tools

  • Citation Tools
    Abstract 11938: Long-term Population-based Outcomes of Novel Oral Anticoagulants Compared to Warfarin Among Long-term Anticoagulated Patients: A Propensity Matched Analysis
    Victoria Jacobs, Heidi T May, Tami L Bair, Jeffrey L Anderson, Brian G Crandall, Michael Cutler, John D Day, Charles D Mallender, Jeffrey S Osborn, Scott M Stevens, J P Weiss, Scott C Woller and T J Bunch
    Circulation. 2015;132:A11938, originally published November 6, 2015

    Citation Manager Formats

    • BibTeX
    • Bookends
    • EasyBib
    • EndNote (tagged)
    • EndNote 8 (xml)
    • Medlars
    • Mendeley
    • Papers
    • RefWorks Tagged
    • Ref Manager
    • RIS
    • Zotero
  • Article Alerts
    Log in to Email Alerts with your email address.
  • Save to my folders

Share this Article

  • Email

    Thank you for your interest in spreading the word on Circulation.

    NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

    Enter multiple addresses on separate lines or separate them with commas.
    Abstract 11938: Long-term Population-based Outcomes of Novel Oral Anticoagulants Compared to Warfarin Among Long-term Anticoagulated Patients: A Propensity Matched Analysis
    (Your Name) has sent you a message from Circulation
    (Your Name) thought you would like to see the Circulation web site.
  • Share on Social Media
    Abstract 11938: Long-term Population-based Outcomes of Novel Oral Anticoagulants Compared to Warfarin Among Long-term Anticoagulated Patients: A Propensity Matched Analysis
    Victoria Jacobs, Heidi T May, Tami L Bair, Jeffrey L Anderson, Brian G Crandall, Michael Cutler, John D Day, Charles D Mallender, Jeffrey S Osborn, Scott M Stevens, J P Weiss, Scott C Woller and T J Bunch
    Circulation. 2015;132:A11938, originally published November 6, 2015
    del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo

Related Articles

Cited By...

Circulation

  • About Circulation
  • Instructions for Authors
  • Circulation CME
  • Statements and Guidelines
  • Meeting Abstracts
  • Permissions
  • Journal Policies
  • Email Alerts
  • Open Access Information
  • AHA Journals RSS
  • AHA Newsroom

Editorial Office Address:
200 Fifth Avenue, Suite 1020
Waltham, MA 02451
email: circ@circulationjournal.org
 

Information for:
  • Advertisers
  • Subscribers
  • Subscriber Help
  • Institutions / Librarians
  • Institutional Subscriptions FAQ
  • International Users
American Heart Association Learn and Live
National Center
7272 Greenville Ave.
Dallas, TX 75231

Customer Service

  • 1-800-AHA-USA-1
  • 1-800-242-8721
  • Local Info
  • Contact Us

About Us

Our mission is to build healthier lives, free of cardiovascular diseases and stroke. That single purpose drives all we do. The need for our work is beyond question. Find Out More about the American Heart Association

  • Careers
  • SHOP
  • Latest Heart and Stroke News
  • AHA/ASA Media Newsroom

Our Sites

  • American Heart Association
  • American Stroke Association
  • For Professionals
  • More Sites

Take Action

  • Advocate
  • Donate
  • Planned Giving
  • Volunteer

Online Communities

  • AFib Support
  • Garden Community
  • Patient Support Network
  • Professional Online Network

Follow Us:

  • Follow Circulation on Twitter
  • Visit Circulation on Facebook
  • Follow Circulation on Google Plus
  • Follow Circulation on Instagram
  • Follow Circulation on Pinterest
  • Follow Circulation on YouTube
  • Rss Feeds
  • Privacy Policy
  • Copyright
  • Ethics Policy
  • Conflict of Interest Policy
  • Linking Policy
  • Diversity
  • Careers

©2018 American Heart Association, Inc. All rights reserved. Unauthorized use prohibited. The American Heart Association is a qualified 501(c)(3) tax-exempt organization.
*Red Dress™ DHHS, Go Red™ AHA; National Wear Red Day ® is a registered trademark.

  • PUTTING PATIENTS FIRST National Health Council Standards of Excellence Certification Program
  • BBB Accredited Charity
  • Comodo Secured