Abstract 14232: Effect of Direct Oral Anticoagulants on Carotid Artery Sclerosis in Patients With Atrial Fibrillation
Introduction: In patients with non-valvular atrial fibrillation (AF), direct oral anticoagulants (DOACs) are at least non-inferior to warfarin for the prevention of stroke and systemic embolism. Anti-inflammatory effects of some DOACs have been shown in animal studies, whereas warfarin had been reported that it promoted atherosclerosis by inhibiting synthesis of anti-calcification factor.
Hypothesis: We hypothesized that atherosclerosis of carotid artery atherosclerosis in patients taking warfarin is more progressed than in patients having DOACs.
Methods: We assessed atherosclerotic changes of the carotid arteries in 85 patients taking DOACs or warfarin (Wf) more than 1 year from January 1, 2013, to October 31, 2015. The mean-carotid intima-media thickness (IMT), max-IMT in both sides of carotid arteries and total plaque score were obtained in all subjects by carotid ultrasonography.
Results: During the study period, 45 patients took DOACs (73 ± 7 years of age, 64% male, average period for prescription: 426±119 days) and 40 patients took warfarin (75 ± 8 years of age, 60% male, average period for prescription: 438±134 days). There were no significant differences in age and gender in the both groups. The mean-IMTs, max-IMTs and total plaque scores were lower in the DOACs group than those in the Wf group, respectively. These significant differences were not found in the sub-group over 75 -year-old.
Conclusions: Carotid artery sclerosis may more develop in patients taking warfarin than in patients taking DOAC, especially in the patient under 75-year-old. The DOAC may have superior effect for atherosclerosis than the warfarin, and it may bring favorable outcomes for cerebrovascular and/or cardiovascular diseases which frequently concomitants with AF.
Author Disclosures: Y. Torii: None. H. Yamada: None. K. Kusunose: None. H. Seno: None. Y. Saijyo: None. Y. Okushi: None. S. Nishio: None. Y. Hirata: None. R. Amano: None. M. Sata: None.
- © 2016 by American Heart Association, Inc.